Skip to main content
Journal cover image

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

Publication ,  Journal Article
Forghani, F; Ginn, JS; Schiff, JP; Zhu, T; Marut, L; Laugeman, E; Maraghechi, B; Badiyan, SN; Samson, PP; Kim, H; Robinson, CG; Hugo, GD ...
Published in: Radiother Oncol
May 2023

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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Radiother Oncol

DOI

EISSN

1879-0887

Publication Date

May 2023

Volume

182

Start / End Page

109603

Location

Ireland

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Pancreatic Neoplasms
  • Organs at Risk
  • Oncology & Carcinogenesis
  • Humans
  • 5105 Medical and biological physics
  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Forghani, F., Ginn, J. S., Schiff, J. P., Zhu, T., Marut, L., Laugeman, E., … Price, A. T. (2023). Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer. Radiother Oncol, 182, 109603. https://doi.org/10.1016/j.radonc.2023.109603
Forghani, Farnoush, John S. Ginn, Joshua P. Schiff, Tong Zhu, Luke Marut, Eric Laugeman, Borna Maraghechi, et al. “Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer.Radiother Oncol 182 (May 2023): 109603. https://doi.org/10.1016/j.radonc.2023.109603.
Forghani F, Ginn JS, Schiff JP, Zhu T, Marut L, Laugeman E, et al. Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer. Radiother Oncol. 2023 May;182:109603.
Forghani, Farnoush, et al. “Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer.Radiother Oncol, vol. 182, May 2023, p. 109603. Pubmed, doi:10.1016/j.radonc.2023.109603.
Forghani F, Ginn JS, Schiff JP, Zhu T, Marut L, Laugeman E, Maraghechi B, Badiyan SN, Samson PP, Kim H, Robinson CG, Hugo GD, Henke LE, Price AT. Knowledge-based adaptive planning quality assurance using dosimetric indicators for stereotactic adaptive radiotherapy for pancreatic cancer. Radiother Oncol. 2023 May;182:109603.
Journal cover image

Published In

Radiother Oncol

DOI

EISSN

1879-0887

Publication Date

May 2023

Volume

182

Start / End Page

109603

Location

Ireland

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Pancreatic Neoplasms
  • Organs at Risk
  • Oncology & Carcinogenesis
  • Humans
  • 5105 Medical and biological physics
  • 3211 Oncology and carcinogenesis