Highlights
- •Clarify the inter-planner variation of knowledge-based plan (KBP) quality.
- •Ninety VMAT plans were created using the RapidPlan by nine planners.
- •Single optimization with only priority modification was performed.
- •Large variation of plan quality was observed in beginner planners.
- •Inter-planner variation remains for complicated plans even though using KBP.
Abstract
Purpose
This study aimed to clarify the inter-planner variation of plan quality in knowledge-based
plans created by nine planners.
Methods
Five hypofractionated prostate-only (HPO) volumetric modulated arc therapy (VMAT)
plans and five whole-pelvis (WP) VMAT plans were created by each planner using a knowledge-based
planning (KBP) system. Nine planners were divided into three groups of three planners
each: Senior, Junior, and Beginner. Single optimization with only priority modification
for all objectives was performed to stay within the dose constraints. The coefficients
of variation (CVs) for dosimetric parameters were evaluated, and a plan quality metric
(PQM) was used to evaluate comprehensive plan quality.
Results
Lower CVs (<0.05) were observed at dosimetric parameters in the planning target volume
for both HPO and WP plans, while the CVs in the rectum and bladder for WP plans (<0.91)
were greater than those for HPO plans (<0.17). The PQM values of HPO plans for Cases1–5
(average ± standard deviation) were 41.2 ± 7.1, 40.9 ± 5.6, and 39.9 ± 4.6 in the
Senior, Junior, and Beginner groups, respectively. For the WP plans, the PQM values
were 51.9 ± 6.3, 47.5 ± 4.3, and 40.0 ± 6.6, respectively. The number of clinically
acceptable HPO and WP plans were 13/15 and 11/15 in the Senior group, 13/15 and 10/15
plans in the Junior group, and 8/15 and 2/15 plans in the Beginner group, respectively.
Conclusion
Inter-planner variation in the plan quality with RapidPlan remains, especially for
the complicated VMAT plans, due to planners’ heuristics.
Keywords
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Article info
Publication history
Published online: November 06, 2019
Accepted:
October 17,
2019
Received in revised form:
October 15,
2019
Received:
June 16,
2019
Identification
Copyright
© 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
