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A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning.

Publication ,  Journal Article
Good, D; Lo, J; Lee, WR; Wu, QJ; Yin, F-F; Das, SK
Published in: Int J Radiat Oncol Biol Phys
September 1, 2013

PURPOSE: Intensity modulated radiation therapy (IMRT) treatment planning can have wide variation among different treatment centers. We propose a system to leverage the IMRT planning experience of larger institutions to automatically create high-quality plans for outside clinics. We explore feasibility by generating plans for patient datasets from an outside institution by adapting plans from our institution. METHODS AND MATERIALS: A knowledge database was created from 132 IMRT treatment plans for prostate cancer at our institution. The outside institution, a community hospital, provided the datasets for 55 prostate cancer cases, including their original treatment plans. For each "query" case from the outside institution, a similar "match" case was identified in the knowledge database, and the match case's plan parameters were then adapted and optimized to the query case by use of a semiautomated approach that required no expert planning knowledge. The plans generated with this knowledge-based approach were compared with the original treatment plans at several dose cutpoints. RESULTS: Compared with the original plan, the knowledge-based plan had a significantly more homogeneous dose to the planning target volume and a significantly lower maximum dose. The volumes of the rectum, bladder, and femoral heads above all cutpoints were nominally lower for the knowledge-based plan; the reductions were significantly lower for the rectum. In 40% of cases, the knowledge-based plan had overall superior (lower) dose-volume histograms for rectum and bladder; in 54% of cases, the comparison was equivocal; in 6% of cases, the knowledge-based plan was inferior for both bladder and rectum. CONCLUSIONS: Knowledge-based planning was superior or equivalent to the original plan in 95% of cases. The knowledge-based approach shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced institutions.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

September 1, 2013

Volume

87

Issue

1

Start / End Page

176 / 181

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Technology Transfer
  • Rectum
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Quality Improvement
  • Prostatic Neoplasms
  • Organs at Risk
 

Citation

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MLA
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Good, D., Lo, J., Lee, W. R., Wu, Q. J., Yin, F.-F., & Das, S. K. (2013). A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning. Int J Radiat Oncol Biol Phys, 87(1), 176–181. https://doi.org/10.1016/j.ijrobp.2013.03.015
Good, David, Joseph Lo, W Robert Lee, Q Jackie Wu, Fang-Fang Yin, and Shiva K. Das. “A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning.Int J Radiat Oncol Biol Phys 87, no. 1 (September 1, 2013): 176–81. https://doi.org/10.1016/j.ijrobp.2013.03.015.
Good, David, et al. “A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning.Int J Radiat Oncol Biol Phys, vol. 87, no. 1, Sept. 2013, pp. 176–81. Pubmed, doi:10.1016/j.ijrobp.2013.03.015.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

September 1, 2013

Volume

87

Issue

1

Start / End Page

176 / 181

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Technology Transfer
  • Rectum
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Quality Improvement
  • Prostatic Neoplasms
  • Organs at Risk