- •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.
This study aimed to clarify the inter-planner variation of plan quality in knowledge-based plans created by nine planners.
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.
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.
Inter-planner variation in the plan quality with RapidPlan remains, especially for the complicated VMAT plans, due to planners’ heuristics.
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- Variation in external beam treatment plan quality: an inter-institutional study of planners and planning systems.Pract Radiat Oncol. 2012; 2: 296-305https://doi.org/10.1016/j.prro.2011.11.012
- Can all centers plan intensity-modulated radiotherapy (IMRT) effectively? An external audit of dosimetric comparisons between three-dimensional conformal radiotherapy and IMRT for adjuvant chemoradiation for gastric cancer.Int J Radiat Oncol Biol Phys. 2008; 71: 1167-1174https://doi.org/10.1016/j.ijrobp.2007.11.040
- How important is dosimetrist experience for intensity modulated radiation therapy? A comparative analysis of a head and neck case.Pract Radiat Oncol. 2013; 3: e99-e106https://doi.org/10.1016/j.prro.2012.06.009
- Plan quality improvement by DVH sharing and planner’s experience: results of a SBRT multicentric planning study on prostate.Phys Med. 2019; 62: 73-82https://doi.org/10.1016/j.ejmp.2019.05.003
- Assessment of a model based optimization engine for volumetric modulated arc therapy for patients with advanced hepatocellular cancer.Radiat Oncol. 2014; 9: 236https://doi.org/10.1186/s13014-014-0236-0
- A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning.Int J Radiat Oncol Biol Phys. 2013; 87: 176-181https://doi.org/10.1016/j.ijrobp.2013.03.015
- Knowledge-based radiation therapy (KBRT) treatment planning versus planning by experts: validation of a KBRT algorithm for prostate cancer treatment planning.Radiat Oncol. 2015; 10: 111https://doi.org/10.1186/s13014-015-0416-6
- Evaluation of a knowledge-based planning solution for head and neck cancer.Int J Radiat Oncol Biol Phys. 2015; 91: 612-620https://doi.org/10.1016/j.ijrobp.2014.11.014
- A broad scope knowledge based model for optimization of VMAT in esophageal cancer: validation and assessment of plan quality among different treatment centers.Radiat Oncol. 2015; 10: 220https://doi.org/10.1186/s13014-015-0530-5
- Dosimetric comparison of RapidPlan and manually optimized plans in volumetric modulated arc therapy for prostate cancer.Phys Med. 2017; 44: 199-204https://doi.org/10.1016/j.ejmp.2017.06.026
- RapidPlan head and neck model: the objectives and possible clinical benefit.Radiat Oncol. 2017; 12: 73https://doi.org/10.1186/s13014-017-0808-x
- Is it possible for knowledge-based planning to improve intensity modulated radiation therapy plan quality for planners with different planning experiences in left-sided breast cancer patients?.Radiat Oncol. 2017; 12: 85https://doi.org/10.1186/s13014-017-0822-z
- Mechanical performance of a commercial knowledge-based VMAT planning for prostate cancer.Radiat Oncol. 2018; 13: 163https://doi.org/10.1186/s13014-018-1114-y
- Evaluation of multiple institutions’ models for knowledge-based planning of volumetric modulated arc therapy (VMAT) for prostate cancer.Radiat Oncol. 2018; 13: 46https://doi.org/10.1186/s13014-018-0994-1
- Evaluating inter-campus plan consistency using a knowledge based planning model.Radiother Oncol. 2016; 120: 349-355https://doi.org/10.1016/j.radonc.2016.06.010
- Comparison of planning quality and efficiency between conventional and knowledge-based algorithms in nasopharyngeal cancer patients using intensity modulated radiation therapy.Int J Radiat Oncol Biol Phys. 2016; 95: 981-990https://doi.org/10.1016/j.ijrobp.2016.02.017
- On the pre-clinical validation of a commercial model-based optimization engine: application to volumetric modulated arc therapy for patients with lung or prostate cancer.Radiother Oncol. 2014; 113: 385-391https://doi.org/10.1016/j.radonc.2014.11.009
- Reducing inter- and intra-planner variability in radiotherapy plan output with a commercial knowledge-based planning solution.Phys Med. 2018; 53: 86-93https://doi.org/10.1016/j.ejmp.2018.08.016
- Comparison of dosimetric parameters and acute toxicity after whole-pelvic vs prostate-only volumetric-modulated arc therapy with daily image guidance for prostate cancer.Br J Radiol. 2016; 89: 20150930https://doi.org/10.1259/bjr.20150930
- Effect of dosimetric outliers on the performance of a commercial knowledge-based planning solution.Int J Radiat Oncol Biol Phys. 2016; 94: 469-477https://doi.org/10.1016/j.ijrobp.2015.11.011
- Homogeneity index: an objective tool for assessment of conformal radiation treatments.J Med Phys. 2012; 37: 207-213https://doi.org/10.4103/0971-6203.103606
- A conformation number to quantify the degree of conformality in brachytherapy and external beam irradiation: application to the prostate.Int J Radiat Oncol Biol Phys. 1997; 37: 731-736https://doi.org/10.1016/S0360-3016(96)00601-3
- Efficiently train and validate a RapidPlan model through APQM scoring.Med Phys. 2018; 45: 2611-2619https://doi.org/10.1002/mp.12896
- Comprehensive intra-institution stepping validation of knowledge-based models for automatic plan optimization.Phys Med. 2019; 57: 231-237https://doi.org/10.1016/j.ejmp.2018.12.002
- Development and evaluation of a clinical model for lung cancer patients using stereotactic body radiotherapy (SBRT) within a knowledge-based algorithm for treatment planning.J Appl Clin Med Phys. 2016; 17: 263-275https://doi.org/10.1120/jacmp.v17i6.6429
- Knowledge-based IMRT planning for individual liver cancer patients using a novel specific model.Radiat Oncol. 2018; 13: 52https://doi.org/10.1186/s13014-018-0996-z
- Multi-institutional evaluation of knowledge-based planning performance of volumetric modulated arc therapy (VMAT) for head and neck cancer.Phys Med. 2019; 64: 174-181https://doi.org/10.1016/j.ejmp.2019.07.004
Published online: November 06, 2019
Accepted: October 17, 2019
Received in revised form: October 15, 2019
Received: June 16, 2019
© 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.