Heinzelmann Feline, Budde Moritz, Adamietz Irenäus A, Kröninger Kevin, Boström Jan P
Department of Physics, TU Dortmund University, Dortmund, Germany.
Marien Hospital Herne, University Hospital at Ruhr-Universität Bochum, Clinic for Radiotherapy and Radiation Oncology, Herne, Germany.
Adv Radiat Oncol. 2022 Jun 29;7(6):101006. doi: 10.1016/j.adro.2022.101006. eCollection 2022 Nov-Dec.
A new inverse planning software called IntuitivePlan (IP) based on a global convex optimization algorithm was adopted for the Gamma Knife radiation surgery. We investigated IP's suitability for daily clinical use and its applicability for different cerebral entities.
For 230 target volumes, IP was tested in a prospective trial. The computed treatment plans were compared with conventional expert preplans, which included forward planning by the expert and local internal optimization. Based on the same dose constraints, we used the default settings for the inverse calculation of the treatment plans. Plan quality metrics such as the Paddick conformity index were compared for both planning techniques with additional subdivisions into the 3 selectable IP planning strategies and different entity groups.
IP calculated treatment plans of quality similar to that of preplans created by expert planners. Some plan quality metrics, especially those related to conformity and dose gradient, attained statistically significantly higher scores combined with high coverage for the inversely generated plans except for the selectivity optimizing strategy. Normal brain volume receiving 10 Gy or 12 Gy or higher ( or did not show significant differences for the coverage optimizing strategies. The IP software demonstrated significantly shorter planning times versus manual planning as well as greater numbers of isocenters, often associated with longer treatment times. In terms of total time, these differences almost balanced out again.
Our results suggest that IP is advantageous for complex tumors. We observed general clinical significance for conformity and superiority for the selectivity optimizing strategy. In addition, the high-quality calculation from IP enables novices in the profession to achieve pre-treatment plans of a quality similar to that of expert planners. IP allows for optimizing the sparing of surrounding tissue and conformity for benign tumors within a short time. Thus, IP forms a solid basis for further planning on the treatment day.
一种基于全局凸优化算法的名为IntuitivePlan（IP）的新型逆向计划软件被应用于伽玛刀放射治疗。我们研究了IP在日常临床使用中的适用性及其对不同脑部病变的适用性。
对230个靶体积，在一项前瞻性试验中测试了IP。将计算出的治疗计划与传统的专家预计划进行比较，传统预计划包括专家的正向计划和局部内部优化。基于相同的剂量约束，我们使用治疗计划逆向计算的默认设置。比较了两种计划技术的计划质量指标，如帕迪克适形指数，并将其进一步细分为3种可选的IP计划策略和不同的病变组。
IP计算的治疗计划质量与专家计划者创建的预计划相似。一些计划质量指标，特别是那些与适形性和剂量梯度相关的指标，除了选择性优化策略外，对于逆向生成的计划，在覆盖率高的情况下，在统计学上获得了显著更高的分数。接受10 Gy或12 Gy及以上剂量的正常脑体积对于覆盖率优化策略没有显示出显著差异。与手动计划相比，IP软件的计划时间显著缩短，并且等中心数量更多，这通常与更长的治疗时间相关。就总时间而言，这些差异几乎再次抵消。
我们的结果表明，IP对于复杂肿瘤具有优势。我们观察到选择性优化策略在适形性方面具有一般临床意义和优越性。此外，IP的高质量计算使该领域的新手能够获得与专家计划者质量相似的治疗前计划。IP允许在短时间内优化周围组织的 sparing 和良性肿瘤的适形性。因此，IP为治疗当天的进一步计划奠定了坚实的基础。
