Varian ethos online adaptive radiotherapy for prostate cancer: Early results of contouring accuracy, treatment plan quality, and treatment time

被引:147
作者
Byrne, Mikel [1 ,2 ]
Archibald-Heeren, Ben [1 ]
Hu, Yunfei [3 ]
Teh, Amy [1 ]
Beserminji, Rhea [1 ]
Cai, Emma [1 ]
Liu, Guilin [1 ]
Yates, Angela [1 ]
Rijken, James [4 ]
Collett, Nick [1 ]
Aland, Trent [5 ]
机构
[1] Sydney Adventist Hosp, Icon Canc Ctr Wahroonga, 185 Fox Valley Rd, Wahroonga, NSW, Australia
[2] Univ Newcastle, Sch Informat & Phys Sci, Newcastle, NSW, Australia
[3] Icon Canc Ctr Gosford, Gosford, NSW, Australia
[4] Icon Canc Ctr Windsor Gardens, Windsor Gardens, SA, Australia
[5] Icon Core Off, South Brisbane, Qld, Australia
关键词
adaptive therapy; deformable registration; machine learning; BEAM COMPUTED-TOMOGRAPHY; CLINICAL IMPLEMENTATION;
D O I
10.1002/acm2.13479
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The Varian Ethos system allows for online adaptive treatments through the utilization of artificial intelligence (AI) and deformable image registration which automates large parts of the anatomical contouring and plan optimization process. In this study, treatments of intact prostate and prostate bed, with and without nodes, were simulated for 182 online adaptive fractions, and then a further 184 clinical fractions were delivered on the Ethos system. Frequency and magnitude of contour edits were recorded, as well as a range of plan quality metrics. From the fractions analyzed, 11% of AI generated contours, known as influencer contours, required no change, and 81% required minor edits in any given fraction. The frequency of target and noninfluencer organs at risk (OAR) contour editing varied substantially between different targets and noninfluencer OARs, although across all targets 72% of cases required no edits. The adaptive plan was the preference in 95% of fractions. The adaptive plan met more goals than the scheduled plan in 78% of fractions, while in 15% of fractions the number of goals met was the same. The online adaptive recontouring and replanning process was carried out in 19 min on average. Significant improvements in dosimetry are possible with the Ethos online adaptive system in prostate radiotherapy.
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页数:11
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