Pre-clinical validation of a novel system for fully-automated treatment planning

Introduction: Many approaches for automated treatment planning (autoplanning) have been proposed and investigated. Autoplanning can enhance plan quality compared to 'manual' trial-and-error planning, and decrease routine planning workload. A few approaches have been implemented in commercial treatment planning systems (TPSs). We performed a pre-clinical validation of a new system ('NovelATP') that is based on fully-automated multi-criterial optimization (MCO). The aim of NovelATP is to automatically generate for each patient a single high-quality, Pareto-optimal plan without manual Pareto navigation. Material and methods: Validation was performed by generating VMAT/IMRT plans for conventional treatment of prostate cancer (101 pts), prostate SBRT (20 pts), bilateral head-and-neck cancer (50 pts) and rectal cancer treated at an MR-Linac (23 pts). NovelATP autoplans were compared to plans that were generated with our in-house autoplanning system. In many previous validation studies, the latter system consistently showed enhanced plan quality when compared to manual planning. Results: Dosimetrical differences between NovelATP and benchmark plans were on average small and presumably not clinically relevant, pointing at high NovelATP dosimetric plan quality. MUs were 11- 19% higher with NovelATP. NovelATP delivery times were up to 12% longer. Overall, there was a slight disadvantage for NovelATP regarding gamma analyses. Calculation times for NovelATP plans were between 29 and 151 min with no overall differences with the benchmark plans. Conclusion: The new autoplanning system was able to produce high-quality plans for four highly different planning protocols/treatment sites with a total of 194 patients investigated. (c) 2021 The Authors. Published by Elsevier B.V. Radiotherapy and Oncology 158 (2021) 253-261 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).