Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona; Department of Radiation Oncology, University of Colorado, Aurora, Colorado.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Scottsdale, Arizona.
Pract Radiat Oncol. 2024 May-Jun;14(3):e236-e248. doi: 10.1016/j.prro.2023.09.009. Epub 2023 Oct 31.
To evaluate dose volume histogram (DVH) construction differences across 8 major commercial treatment planning systems (TPS) and dose reporting systems for clinically treated plans of various anatomic sites and target sizes.
Dose files from 10 selected clinically treated plans with a hypofractionation, stereotactic radiation therapy prescription or sharp dose gradients such as head and neck plans ranging from prescription doses of 18 Gy in 1 fraction to 70 Gy in 35 fractions, each calculated at 0.25 and 0.125 cm grid size, were created and anonymized in Eclipse TPS, and exported to 7 other major TPS (Pinnacle, RayStation, and Elements) and dose reporting systems (MIM, Mobius, ProKnow, and Velocity) systems for comparison. Dose-volume constraint points of clinical importance for each plan were collected from each evaluated system (D0.03 cc [Gy], volume, and the mean dose were used for structures without specified constraints). Each reported constraint type and structure volume was normalized to the value from Eclipse for a pairwise comparison. A Wilcoxon rank-sum test was used for statistical significance and a multivariable regression model was evaluated adjusting for plan, grid size, and distance to target center.
For all DVH points relative to Eclipse, all systems reported median values within 1.0% difference of each other; however, they were all different from Eclipse. Considering mean values, Pinnacle, RayStation, and Elements averaged at 1.038, 1.046, and 1.024, respectively, while MIM, Mobius, ProKnow, and Velocity reported 1.026, 1.050, 1.033, and 1.022, respectively relative to Eclipse. Smaller dose grid size improved agreement between the systems marginally without statistical significance. For structure volumes relative to Eclipse, larger differences are seen across all systems with a range in median values up to 3.0% difference and mean up to 10.1% difference.
Large variations were observed between all systems. Eclipse generally reported, at statistically significant levels, lower values than all other evaluated systems. The nonsignificant change resulting from lowering the dose grid resolution indicates that this resolution may be less important than other aspects of calculating DVH curves, such as the 3-dimensional modeling of the structure.
评估 8 种主要商业治疗计划系统 (TPS) 和剂量报告系统在不同解剖部位和靶区大小的临床治疗计划中构建剂量体积直方图 (DVH) 的差异。
从 10 例接受过适形分割、立体定向放射治疗处方或剂量梯度陡峭治疗的患者的临床治疗计划中创建并匿名化剂量文件，处方剂量范围从单次 18 Gy 到 35 次 70 Gy，分别在 0.25 和 0.125 cm 网格大小下进行计算，然后将这些剂量文件导入到 7 种其他主要 TPS（Pinnacle、RayStation 和 Elements）和剂量报告系统（MIM、Mobius、ProKnow 和 Velocity）中进行比较。从每个评估系统中收集每个计划的临床重要剂量-体积约束点（D0.03 cc [Gy]、体积和平均剂量用于没有指定约束的结构）。报告的每种约束类型和结构体积都相对于 Eclipse 进行归一化，以便进行成对比较。使用 Wilcoxon 秩和检验进行统计学意义检验，并通过调整计划、网格大小和靶区中心距离的多变量回归模型进行评估。
对于所有相对于 Eclipse 的 DVH 点，所有系统报告的中位数值彼此之间的差异都在 1.0%以内；然而，它们都与 Eclipse 不同。考虑平均值，Pinnacle、RayStation 和 Elements 分别平均为 1.038、1.046 和 1.024，而 MIM、Mobius、ProKnow 和 Velocity 分别报告为 1.026、1.050、1.033 和 1.022。较小的剂量网格尺寸略微改善了系统之间的一致性，但没有统计学意义。对于相对于 Eclipse 的结构体积，所有系统之间的差异较大，中位数值的范围高达 3.0%，平均值高达 10.1%。
所有系统之间都观察到了较大的差异。Eclipse 通常以具有统计学意义的水平报告低于所有其他评估系统的值。降低剂量网格分辨率没有产生显著变化，这表明这种分辨率可能不如计算 DVH 曲线的其他方面重要，例如结构的三维建模。
