Assessing population-based to personalized planning strategies for head and neck adaptive radiotherapy

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2024-12-03 DOI:10.1002/acm2.14576

Justin Visak, Chien-Yi Liao, Xinran Zhong, Biling Wang, Sean Domal, Hui-Ju Wang, Austen Maniscalco, Arnold Pompos, Dan Nyguen, David Parsons, Andrew Godley, Weiguo Lu, Steve Jiang, Dominic Moon, David Sher, Mu-Han Lin

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引用次数: 0

Abstract

Purpose

Optimal head-and-neck cancer (HNC) treatment planning requires accurate and feasible planning goals to meet dosimetric constraints and generate robust online adaptive treatment plans. A new x-ray-based adaptive radiotherapy (ART) treatment planning system (TPS) version 2.0 emulator includes novel methods to drive the planning process including the revised intelligent optimization engine algorithm (IOE2). HNC is among the most challenging and complex sites and heavily depends on planner skill and experience to successfully generate a reference plan. Therefore, we evaluate the new TPS performance via conventionally accepted planning strategies with/without artificial intelligence (AI) and knowledge-based planning (KBP).

Methods

Our institution has a pre-clinical release of the Varian Ethos2.0 TPS emulator which includes several changes that may affect current planning strategies. Twenty definitive and post-operative HNC patients were retrospectively selected with a two or three-level simultaneous integrated boost (SIB) dosing scheme. Patients were replanned in the emulator using population-based, KBP-guided with/without human intervention and AI-guided planning goals. These planning strategies were compared both dosimetrically and for plan deliverability.

Results

All strategies generally demonstrated acceptable plan quality with KBP- and AI-guided goals offering enhanced dosimetric sparing in organs-at-risk (OAR). The average contralateral parotid gland mean dose was 20.0 ± 6.1 Gy (p < 0.001) for population-based and 15.0 ± 6.1 Gy (p = n.s.) for KBP-with human intervention versus 15.1 ± 7.4 Gy for clinical plans. Target coverage, minimum dose, and plan hotspot were acceptable in all cases. KBP-enabled strategy demonstrated higher modulation and faster optimization time than both population-based and AI-guided strategies.

Conclusion

Simply entering population, automatic KBP-enabled or AI-generated planning goals into the new Ethos2.0 TPS produced dosimetrically compliant plans, with AI-guided goals demonstrating the most OAR sparing. Several of these approaches are easy to translate to other treatment sites and will help lower the barrier to entry for x-ray-based online-ART.

Abstract Image

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评估基于人群的头颈部适应性放疗的个性化规划策略。

目的：最佳头颈癌（HNC）治疗计划需要准确可行的计划目标，以满足剂量学约束，并生成稳健的在线自适应治疗计划。一个新的基于x射线的自适应放疗（ART）治疗计划系统（TPS） 2.0版仿真器包含了新的方法来驱动计划过程，包括修订的智能优化引擎算法（IOE2）。HNC是最具挑战性和最复杂的场地之一，在很大程度上取决于规划师的技能和经验，以成功地生成一个参考计划。因此，我们通过使用/不使用人工智能（AI）和基于知识的规划（KBP）的传统规划策略来评估新的TPS性能。方法：我们的机构已经发布了Varian Ethos2.0 TPS模拟器的临床前版本，其中包括一些可能影响当前规划策略的更改。回顾性选择20例确诊和术后HNC患者，采用两级或三级同步综合增强（SIB）给药方案。在模拟器中使用基于人群的、kbp引导的、有/没有人为干预的和人工智能引导的计划目标对患者进行重新计划。对这些规划策略进行了剂量学和计划可交付性的比较。结果：所有策略总体上都表现出可接受的计划质量，具有KBP和ai指导的目标，在危险器官（OAR）中提供了增强的剂量节约。结论：简单地将人群、自动启用kbp或人工智能生成的计划目标输入到新的Ethos2.0 TPS中，产生了剂量学上符合要求的计划，人工智能引导的目标显示出最大的OAR节约。其中一些方法很容易转化为其他治疗场所，并将有助于降低基于x射线的在线art的进入门槛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic