Abstract
This work evaluated a commercial fallback planning workflow designed to provide cross-platform treatment planning and delivery. A total of 27 helical tomotherapy intensity-modulated radiotherapy plans covering 4 anatomical sites were selected, including 7 brain, 5 unilateral head and neck, 5 bilateral head and neck, 5 pelvis, and 5 prostate cases. All helical tomotherapy plans were converted to 7-field/9-field intensity-modulated radiotherapy and volumetric-modulated radiotherapy plans through fallback dose-mimicking algorithm using a 6-MV beam model. The planning target volume (PTV) coverage ( D1, D99, and homogeneity index) and organs at risk dose constraints were evaluated and compared. Overall, all 3 techniques resulted in relatively inferior target dose coverage compared to helical tomotherapy plans, with higher homogeneity index and maximum dose. The organs at risk dose ratio of fallback to helical tomotherapy plans covered a wide spectrum, from 0.87 to 1.11 on average for all sites, with fallback plans being superior for brain, pelvis, and prostate sites. The quality of fallback plans depends on the delivery technique, field numbers, and angles, as well as user selection of structures for organs at risk. In actual clinical scenario, fallback plans would typically be needed for 1 to 5 fractions of a treatment course in the event of machine breakdown. Our results suggested that <1% dose variance can be introduced in target coverage and/or organs at risk from fallback plans. The presented clinical workflow showed that the fallback plan generation typically takes 10 to 20 minutes per case. Fallback planning provides an expeditious and effective strategy for transferring patients cross platforms, and minimizing the untold risk of a patient missing treatment(s).
| Original language | English (US) |
|---|---|
| Journal | Technology in cancer research & treatment |
| Volume | 17 |
| DOIs | |
| State | Published - Jan 1 2018 |
Fingerprint
Keywords
- fallback planning
- helical tomotherapy
- homogeneity index
- intensity-modulated radiotherapy
- volumetric-modulated radiotherapy
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Converting Treatment Plans From Helical Tomotherapy to L-Shape Linac : Clinical Workflow and Dosimetric Evaluation. / Yuan, Zilong; Nair, Chithra Kumaran; Benedict, Stanley H; Valicenti, Richard K; Rao, Shyam; Fragoso, Ruben C; Wright, Cari; Qiu, Jianfeng; Rong, Yi.
In: Technology in cancer research & treatment, Vol. 17, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Converting Treatment Plans From Helical Tomotherapy to L-Shape Linac
T2 - Clinical Workflow and Dosimetric Evaluation
AU - Yuan, Zilong
AU - Nair, Chithra Kumaran
AU - Benedict, Stanley H
AU - Valicenti, Richard K
AU - Rao, Shyam
AU - Fragoso, Ruben C
AU - Wright, Cari
AU - Qiu, Jianfeng
AU - Rong, Yi
PY - 2018/1/1
Y1 - 2018/1/1
N2 - This work evaluated a commercial fallback planning workflow designed to provide cross-platform treatment planning and delivery. A total of 27 helical tomotherapy intensity-modulated radiotherapy plans covering 4 anatomical sites were selected, including 7 brain, 5 unilateral head and neck, 5 bilateral head and neck, 5 pelvis, and 5 prostate cases. All helical tomotherapy plans were converted to 7-field/9-field intensity-modulated radiotherapy and volumetric-modulated radiotherapy plans through fallback dose-mimicking algorithm using a 6-MV beam model. The planning target volume (PTV) coverage ( D1, D99, and homogeneity index) and organs at risk dose constraints were evaluated and compared. Overall, all 3 techniques resulted in relatively inferior target dose coverage compared to helical tomotherapy plans, with higher homogeneity index and maximum dose. The organs at risk dose ratio of fallback to helical tomotherapy plans covered a wide spectrum, from 0.87 to 1.11 on average for all sites, with fallback plans being superior for brain, pelvis, and prostate sites. The quality of fallback plans depends on the delivery technique, field numbers, and angles, as well as user selection of structures for organs at risk. In actual clinical scenario, fallback plans would typically be needed for 1 to 5 fractions of a treatment course in the event of machine breakdown. Our results suggested that <1% dose variance can be introduced in target coverage and/or organs at risk from fallback plans. The presented clinical workflow showed that the fallback plan generation typically takes 10 to 20 minutes per case. Fallback planning provides an expeditious and effective strategy for transferring patients cross platforms, and minimizing the untold risk of a patient missing treatment(s).
AB - This work evaluated a commercial fallback planning workflow designed to provide cross-platform treatment planning and delivery. A total of 27 helical tomotherapy intensity-modulated radiotherapy plans covering 4 anatomical sites were selected, including 7 brain, 5 unilateral head and neck, 5 bilateral head and neck, 5 pelvis, and 5 prostate cases. All helical tomotherapy plans were converted to 7-field/9-field intensity-modulated radiotherapy and volumetric-modulated radiotherapy plans through fallback dose-mimicking algorithm using a 6-MV beam model. The planning target volume (PTV) coverage ( D1, D99, and homogeneity index) and organs at risk dose constraints were evaluated and compared. Overall, all 3 techniques resulted in relatively inferior target dose coverage compared to helical tomotherapy plans, with higher homogeneity index and maximum dose. The organs at risk dose ratio of fallback to helical tomotherapy plans covered a wide spectrum, from 0.87 to 1.11 on average for all sites, with fallback plans being superior for brain, pelvis, and prostate sites. The quality of fallback plans depends on the delivery technique, field numbers, and angles, as well as user selection of structures for organs at risk. In actual clinical scenario, fallback plans would typically be needed for 1 to 5 fractions of a treatment course in the event of machine breakdown. Our results suggested that <1% dose variance can be introduced in target coverage and/or organs at risk from fallback plans. The presented clinical workflow showed that the fallback plan generation typically takes 10 to 20 minutes per case. Fallback planning provides an expeditious and effective strategy for transferring patients cross platforms, and minimizing the untold risk of a patient missing treatment(s).
KW - fallback planning
KW - helical tomotherapy
KW - homogeneity index
KW - intensity-modulated radiotherapy
KW - volumetric-modulated radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85056701661&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056701661&partnerID=8YFLogxK
U2 - 10.1177/1533033818785279
DO - 10.1177/1533033818785279
M3 - Article
VL - 17
JO - Technology in Cancer Research and Treatment
JF - Technology in Cancer Research and Treatment
SN - 1533-0346
ER -