Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer

被引：3

作者：

Forghani, Farnoush ^{[1
,3
]}

Ginn, John S. ^{[2
]}

Schiff, Joshua P. ^{[1
]}

Zhu, Tong ^{[1
]}

Marut, Luke ^{[1
]}

Laugeman, Eric ^{[1
]}

Maraghechi, Borna ^{[1
]}

Badiyan, Shahed N. ^{[1
]}

Samson, Pamela P. ^{[1
]}

Kim, Hyun ^{[1
]}

Robinson, Clifford G. ^{[1
]}

Hugo, Geoffrey D. ^{[1
]}

Henke, Lauren E. ^{[1
]}

Price, Alex T. ^{[1
,3
]}

机构：

[1] Washington Univ, Dept Radiat Oncol, Sch Med, St Louis, MO USA

[2] Duke Univ, Dept Radiat Oncol, Durham, NC USA

[3] Washington Univ, Dept Radiat Oncol, Sch Med, 4921 Parkview Pl,Campus Box 8224, St Louis, MO 63110 USA

来源：

RADIOTHERAPY AND ONCOLOGY | 2023年 / 182卷

关键词：

Adaptive radiotherapy; Knowledge-based planning; Clinical QA trial; Pancreatic cancer; MODULATED RADIATION-THERAPY; ONLINE; CENTERS; TRIAL; SMART;

D O I：

10.1016/j.radonc.2023.109603

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: We aimed to develop knowledge-based tools for robust adaptive radiotherapy (ART) planning to determine on-table adaptive DVH metric variations or planning process errors for stereotactic pancreatic ART. We developed volume-based dosimetric identifiers to identify deviations of ART plans from simulation plans. Materials and Methods: Two patient cohorts who were treated on MR-Linac for pancreas cancer were included in this retrospective study; a training cohort and a validation cohort. All patients received 50 Gy in 5 fractions. PTV-OPT was generated by subtracting the critical organs plus a 5 mm-margin from PTV. Several metrics that potentially can identify failure-modes were calculated including PTV & PTV_OPT V95% and PTV & PTV_OPT D95%/D5%. The difference between each DVH metric in each adaptive plan with the DVH metric in simulation plan was calculated. The 95% confidence interval (CI) of the variations in each DVH metric was calculated for the patient training cohort. Variations in DVH metrics that exceeded the 95% CI for all fractions in training and validation cohort were flagged for retrospective investigation for root-cause analysis to determine their predictive power for identifying failure-modes. Results: The CIs for the PTV & PTV_OPT V95% and PTV & PTV_OPT D95%/D5% were +/- 13%, +/- 5%, +/- 0.1, +/- 0.03, respectively. We estimated the positive predictive value and negative predictive value of our method to be 77% and 89%, respectively, for the training cohort, and 80% for both in the validation cohort. Discussion: We developed dosimetric indicators for ART planning QA to identify population-based deviations or planning errors during online adaptive process for stereotactic pancreatic ART. This technology may be useful as an ART clinical trial QA tool and improve overall ART quality at an institution. (c) 2023 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 182 (2023) 1-7

引用

页数：7

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