Assessment of specific versus combined purpose knowledge based models in prostate radiotherapy

Elizabeth Bossart, Melissa Duffy, Garrett Simpson, Matthew C Abramowitz, Alan Pollack, Nesrin Dogan

Research output: Contribution to journalArticle

Abstract

Knowledge-based planning (KBP) can be used to improve plan quality, planning speed, and reduce the inter-patient plan variability. KPB may also identify and reduce systematic variations in VMAT plans, something very important in multi-institutional clinical trials. Training of a KBP library is a complex and difficult process, and models must be validated prior to their clinical use. The purpose of this work is to assess the quality of the treatment plans generated using a specific versus combined purpose model KBP library for prostate cancer. Seven KBP model libraries were created from a set of patients treated on various Institutional Review Board (IRB) approved protocols. All KBP libraries were validated using an independent set of twenty patients (half treated Pr: Prostate alone half treated PLN: prostate plus pelvic lymph nodes). Two models were tested on the Pr patients only, four tested on PLN patients only, and one tested on all patients. All plans were normalized such that at least 95% of the prostate planning target volume received 100% of the planned dose. The plans based on different model libraries were compared to each other and the expert clinical plan. For Pr plans there were almost no statistically significant differences (P < 0.008) between the plans types except conformity index (CI) with library plans better than the expert. For PLN plans, all model libraries in generally showed femur doses and CI better than the expert plans (P < 0.003). This study demonstrated that no large differences were observed between specific versus combined KBP model libraries in dosimetry of prostate cancer patients. This would allow for a fewer specific plans to be needed to create a model library. Further studies are needed to evaluate benefits of combined purpose model libraries for planning of complex sites such as head and neck cancer.

Original languageEnglish (US)
JournalJournal of Applied Clinical Medical Physics
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Radiotherapy
Libraries
Prostate
radiation therapy
planning
Planning
cancer
Prostatic Neoplasms
Research Ethics Committees
Head and Neck Neoplasms
femur
dosage
Femur
Dosimetry
lymphatic system
Lymph Nodes
Clinical Trials
dosimeters
education

Keywords

  • knowledge based planning
  • model library
  • prostate cancer
  • radiation therapy
  • treatment planning

ASJC Scopus subject areas

  • Radiation
  • Instrumentation
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Assessment of specific versus combined purpose knowledge based models in prostate radiotherapy",
abstract = "Knowledge-based planning (KBP) can be used to improve plan quality, planning speed, and reduce the inter-patient plan variability. KPB may also identify and reduce systematic variations in VMAT plans, something very important in multi-institutional clinical trials. Training of a KBP library is a complex and difficult process, and models must be validated prior to their clinical use. The purpose of this work is to assess the quality of the treatment plans generated using a specific versus combined purpose model KBP library for prostate cancer. Seven KBP model libraries were created from a set of patients treated on various Institutional Review Board (IRB) approved protocols. All KBP libraries were validated using an independent set of twenty patients (half treated Pr: Prostate alone half treated PLN: prostate plus pelvic lymph nodes). Two models were tested on the Pr patients only, four tested on PLN patients only, and one tested on all patients. All plans were normalized such that at least 95{\%} of the prostate planning target volume received 100{\%} of the planned dose. The plans based on different model libraries were compared to each other and the expert clinical plan. For Pr plans there were almost no statistically significant differences (P < 0.008) between the plans types except conformity index (CI) with library plans better than the expert. For PLN plans, all model libraries in generally showed femur doses and CI better than the expert plans (P < 0.003). This study demonstrated that no large differences were observed between specific versus combined KBP model libraries in dosimetry of prostate cancer patients. This would allow for a fewer specific plans to be needed to create a model library. Further studies are needed to evaluate benefits of combined purpose model libraries for planning of complex sites such as head and neck cancer.",
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