Abstract
Background and purposeLinac-based stereotactic radiosurgery (SRS) planning for multi-metastatic cases is a complex and intensive process. A manual planning strategy starts with a template-based set of beam angles and applies modifications though a trial and error process. Beam angle optimization uses patient specific geometric heuristics to determine beam angles that provide optimal target coverage and avoid treating through Organs-at-Risk (OARs). This study expands on a collision prediction application developed using an application programming interface, integrating beam angle optimization and collision prediction into a Stereotactic Optimized Automated Radiotherapy (SOAR) planning algorithm.Materials and methodsTwenty-five patient plans, previously treated with SRS for multi-metastatic intracranial tumors, were selected for a retrospective plan study comparing the manual planning strategy to SOAR. The SOAR algorithm was used to select isocenters, table, collimator, and gantry angles, and target groupings for the optimized plans. Dose-volume metrics for relevant OARs and PTVs were compared using double-sided Wilcoxon signed rank tests (α = 0.05). A subset of five patients were included in an efficiency study comparing manual planning times to SOAR automated times.ResultsOAR dose metrics compared between planning strategies showed no statistical difference for the dataset of twenty-five plans. Differences in maximum PTV dose and the conformity index were improved for SOAR planning and statistically significant. The median SOAR planning time was 9.8 min compared to 55 min for the manual planning strategy.ConclusionsSOAR planning was comparable in plan quality to a manual planning strategy with the possibility for greatly improving planning efficiency through automation.
Highlights
Stereotactic radiosurgery (SRS) delivers a high biologically effective dose in a single treatment to intra-cranial lesions
The median time saved was 45.2 min with a total range of 9.4 min to 326.8 min. This retrospective study compared a manual Volumetric Modulated Arc Therapy (VMAT) planning strat egy to an automated solution that uses beam angle optimization, colli sion prediction, and a treatment planning system Application Programming Interface (API) to efficiently create SRS treatment plans for linac-based multi-metastatic radio surgery
Outliers for volume receiving at least 10 Gy (V10Gy) and V12Gy were reduced by 24.0 cm3 and 11.9 cm3 using Stereotactic Optimized Automated Radiotherapy (SOAR) planning
Summary
Stereotactic radiosurgery (SRS) delivers a high biologically effective dose in a single treatment to intra-cranial lesions. MLCs improve treatment efficiency over other SRS modalities because of their ability to treat multiple targets using a single isocenter. Linac-based stereotactic radiosurgery (SRS) planning for multi-metastatic cases is a complex and intensive process. Materials and methods: Twenty-five patient plans, previously treated with SRS for multi-metastatic intracranial tumors, were selected for a retrospective plan study comparing the manual planning strategy to SOAR. A subset of five patients were included in an efficiency study comparing manual planning times to SOAR automated times. Results: OAR dose metrics compared between planning strategies showed no statistical difference for the dataset of twenty-five plans. Conclusions: SOAR planning was comparable in plan quality to a manual planning strategy with the possibility for greatly improving planning efficiency through automation
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