BreastWatch: A Varian Eclipse script tool for Community-Based automatic evaluation of breast treatment plans.

PURPOSE

This work introduces BreastWatch, a Varian Eclipse script tool designed to help medical physicists, dosimetrists, and radiation oncologists easily inspect and improve External Beam Breast Treatment (EBBT) plans using automatic evaluation of protocol dose-constraints enhanced by a Community-Based approach.

METHODS

BreastWatch examines Eclipse EBBT Plans and Plan Sums, automatically testing the plan's DVH against built-in international EBBT protocol (NRG RTOG1005, ICR Fast-Forward, ICR FAST, and EUROPA 1.2) dose-constraints. Results are displayed using traffic lights and an overall BW-SCORE. To overcome protocol dose-constraints limitations, the script can export plan data and dose values in CSV format to build a Community-Based Plan Library. These data are automatically read back in BreastWatch to check plans against the statistical distribution of similar Community plans and compute a CB-SCORE, which complements the protocol-based BW-SCORE. In this paper, BreastWatch v.1.6.5.0 script's design and strengths are examined and discussed, after extensive testing with more than 800 EBBT plans by six experienced planners. In a preliminary analysis, the usefulness of the CB approach is investigated by examining the chronological series of two dose-constraints values (Contra-Lung V3Gy and Heart Average Dose) before and after its introduction in BreastWatch.

RESULTS

We found BreastWatch to speed up the EBBT planning process, while at the same time helping to improve the treatment plans in terms of PTVs coverage and uniformity, sparing of OARs, consistency, and robustness among different planners. The preliminary analysis of the chronological series of two dose-constraints values for a subgroup of 68 EBBT plans shows a trend (p-value = 0.07) for values to be improved and more consistent after the CB approach introduction.

CONCLUSIONS

The BreastWatch script is a useful tool for the automatic evaluation of Eclipse EBBT plans. BreastWatch and its Community-Based features have been found to be a simple but effective automation approach to improve the EBBT planning process.