Knowledge-based IMRT planning for individual liver cancer patients using a novel specific model

• Published in: Radiation oncology (London, England) Vol. 13; no. 1; pp. 52 - 8
• Main Authors: Yu, Gang, Li, Yang, Feng, Ziwei, Tao, Cheng, Yu, Zuyi, Li, Baosheng, Li, Dengwang
• Format: Journal Article
• Language: English
• Published: London BioMed Central 27.03.2018; BMC
• Subjects: Biomedical and Life Sciences; Biomedicine; Cancer Research; Clinical Radiation Oncology; Imaging; IMRT; Knowledge-based planning; Liver cancer; Oncology; Radiology; Radiotherapy; Specific model; Liver cancer; Specific model; Knowledge-based planning; IMRT
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/s13014-018-0996-z

Background The purpose of this work is to benchmark RapidPlan against clinical plans for liver Intensity-modulated radiotherapy (IMRT) treatment of patients with special anatomical characteristics, and to investigate the prediction capability of the general model (Model-G) versus our specific model (Model-S). Methods A library consisting of 60 liver cancer patients with IMRT planning was used to set up two models (Model-S, Model-G), using the RapidPlan knowledge-based planning system. Model-S consisted of 30 patients with special anatomical characteristics where the distance from planning target volume (PTV) to the right kidney was less than three centimeters and Model-G was configurated using all 60 patients in this library. Knowledge-based IMRT plans were created for the evaluation group formed of 13 patients similar to those included in Model-S by Model-G, Model-S and manually (M), named RPG-plans, RPS-plans and M-plans, respectively. The differences in the dose-volume histograms (DVHs) were compared, not only between RP-plans and their respective M-plans, but also between RPG-plans and RPS-plans. Results For all 13 patients, RapidPlan could automatically produce clinically acceptable plans. Comparing RP-plans to M-plans, RP-plans improved V 95% of PTV and had greater dose sparing in the right kidney. For the normal liver, RPG-plans delivered similar doses, while RPS-plans delivered a higher dose than M-plans. With respect to RapidPlan models, RPS-plans had better conformity index (CI) values and delivered lower doses to the right kidney V 20Gy and maximizing point doses to spinal cord, while delivering higher doses to the normal liver. Conclusion The study shows that RapidPlan can create high-quality plans, and our specific model can improve the CI of PTV, resulting in more sparing of OAR in IMRT for individual liver cancer patients.