Implementation of automated personalised breast radiotherapy planning techniques with scripting in Raystation.

Abstract

Implement scripted automatic breast planning (AP) for breast techniques within Raystation. Manual plans (MPs) were re-planned and compared with AP plans for whole breast (WB), partial breast (PB), hybrid volumetric modulated arc therapy simultaneous integrated boost (VMAT SIB) and VMAT nodal plans. WB AP plans took 7 min comparing well to MP. One WB AP failed a mandatory dose constraint. Small statistically significant differences showed improved coverage for AP at expense of slightly hotter plans, however absolute differences were small (mean differences < 1% or D 0.5cc<0.2 Gy). PB AP plans took 9 min, showing improved coverage (V 24.7Gy97.6 vs 96.4 %). One PB AP case failed a mandatory constraint. Other dosimetric differences were non-significant. SIB AP plans took 14 min with one case failing a mandatory constraint with minor differences compared with MP except larger V 42.8Gy (3 vs 1.5 %) and more MU. VMAT AP plans took 12 min and were hotter for PTVp_4000 but had higher nodal coverage. Contra_Lung V 2.5Gy was higher (8.8 %) than MP plans (6.5 %). Automatic planning of modern breast techniques has been successfully introduced using a commercial planning system. AP plans are very similar to MP, requiring little manual interaction for most cases with significant timesaving potential. Scripted breast plans produced within minutes for WB, PB, SIB and VMAT. Successfully introduced into large busy department. Plans similar to manual plans, requiring little manual interaction.