Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
J Appl Clin Med Phys. 2024 Sep;25(9):e14464. doi: 10.1002/acm2.14464. Epub 2024 Jul 19.
To assess the practicality of employing a commercial knowledge-based planning tool (RapidPlan) to generate adapted intact prostate and prostate bed volumetric modulated arc therapy (VMAT) plans on iterative cone-beam computed tomography (iCBCT) datasets.
Intact prostate and prostate bed RapidPlan models were trained utilizing planning data from 50 and 44 clinical cases, respectively. To ensure that refined models were capable of producing adequate clinical plans with a single optimization, models were tested with 50 clinical planning CT datasets by comparing dose-volume histogram (DVH) and plan quality metric (PQM) values between clinical and RapidPlan-generated plans. The RapidPlan tool was then used to retrospectively generate adapted VMAT plans on daily iCBCT images for 20 intact prostate and 15 prostate bed cases. As before, DVH and PQM metrics were utilized to dosimetrically compare scheduled (iCBCT Verify) and adapted (iCBCT RapidPlan) plans. Timing data was collected to further evaluate the feasibility of integrating this approach within an online adaptive radiotherapy workflow.
Model testing results confirmed the models were capable of producing VMAT plans within a single optimization that were overall improved upon or dosimetrically comparable to original clinical plans. Direct application of RapidPlan on iCBCT datasets produced satisfactory intact prostate and prostate bed plans with generally improved target volume coverage/conformality and rectal sparing relative to iCBCT Verify plans as indicated by DVH values, though bladder metrics were marginally increased on average. Average PQM values for iCBCT RapidPlans were significantly improved compared to iCBCT Verify plans. The average time required [in mm:ss] to generate adapted plans was 06:09 ± 02:06 (intact) and 07:12 ± 01:04 (bed).
This study demonstrated the feasibility of leveraging RapidPlan to expeditiously generate adapted VMAT intact prostate and prostate bed plans on iCBCT datasets. In general, adapted plans were dosimetrically improved relative to scheduled plans, emphasizing the practicality of the proposed approach.
评估在迭代锥形束 CT（iCBCT）数据集上使用商业知识库计划工具（RapidPlan）生成适应性完整前列腺和前列腺床容积调制弧形治疗（VMAT）计划的实用性。
分别使用 50 例和 44 例临床病例的计划数据来训练完整前列腺和前列腺床 RapidPlan 模型。为了确保精细模型能够通过单次优化生成足够的临床计划，使用 50 例临床计划 CT 数据集对模型进行测试，通过比较临床和 RapidPlan 生成计划的剂量体积直方图（DVH）和计划质量度量（PQM）值。然后，使用 RapidPlan 工具在 20 例完整前列腺和 15 例前列腺床病例的每日 iCBCT 图像上回溯生成适应性 VMAT 计划。与之前一样，使用 DVH 和 PQM 度量对计划（iCBCT Verify）和适应性（iCBCT RapidPlan）计划进行剂量学比较。收集时间数据以进一步评估在在线自适应放疗工作流程中集成此方法的可行性。
模型测试结果证实，模型能够在单次优化中生成 VMAT 计划，这些计划总体上优于或与原始临床计划在剂量学上相当。直接在 iCBCT 数据集上应用 RapidPlan 可生成令人满意的完整前列腺和前列腺床计划，与 iCBCT Verify 计划相比，目标体积覆盖率/适形性和直肠保护通常得到改善，尽管膀胱指标平均略有增加。与 iCBCT Verify 计划相比，iCBCT RapidPlan 的平均 PQM 值有显著提高。生成适应性计划所需的平均时间[mm：ss]为 06:09±02:06（完整）和 07:12±01:04（床）。
本研究证明了利用 RapidPlan 在 iCBCT 数据集上快速生成适应性 VMAT 完整前列腺和前列腺床计划的可行性。总体而言，与计划相比，适应性计划在剂量学上有所改善，这强调了所提出方法的实用性。
