The implementation of knowledge-based planning with partial OAR contours for prostate radiotherapy

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

Journal of Applied Clinical Medical Physics Pub Date : 2025-02-07 DOI:10.1002/acm2.70004

Ositomiwa O. Osipitan, David Wiant, Han Liu

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引用次数: 0

Abstract

Purpose

Intra- and inter-observer contour uncertainty is a continuous challenge in treatment planning for radiotherapy. Our proposed solution to address this challenge is the use of partial contours for treatment planning, focusing on uninvolved or non-overlapping portions of the organs-at-risk (OARs) with the planning target volume (PTV).

Methods

The partial contours systematically eliminate overlapping regions. The partial contours were evaluated against fully contoured OARs. We incorporated advanced tools like knowledge-based planning (KBP) to create treatment plans and artificial intelligence (AI) to create auto-segmented contours. We developed two models, Rapid Plan (RP) and Rapid Plan partial uninvolved (RP_Part_Un), using 70 previous clinically approved volumetric arc therapy (VMAT) plans each prescribed with 70 Gy/28 fractions. From these models, we created three plans, RP, RP_Part_Un, and MIM AI_Part_Un. In this retrospective study, 60 prostate patients were analyzed using the three plans. For determining OAR sparing, D_max and D_mean along the percent volume receiving a dose over a range (V₁₀ Gy V₇₀ Gy) between each plan were compared. Geometric evaluations, dice similarity coefficient (DSC), and overlay index (OI) between the OAR contours from partial-contoured manual structure sets and partial-contoured AI structure sets were analyzed.

Results

When comparing the DSC and OI for full contours to the partial contours, in both groups, all comparisons were significantly increased for both organs. This indicated the partial contours had a higher degree of concordance. In patients with SpaceOAR, RP_Part_Un plans exhibited significantly reduced bladder D_max and D_mean compared to RP plans, while rectum D_max and D_mean showed no significant differences. For patients without SpaceOAR, RP_Part_Un significantly lowered rectum D_mean. MIM AI_Part_Un plans demonstrated lower rectum D_max in both patient groups.

Conclusions

Partial contours, defined at a specified distance from the PTV, yielded dosimetry comparable to fully contoured plans, highlighting their potential efficacy in treatment planning.

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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