Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy

Roel G J Kierkels, Ruurd Visser, Hendrik P Bijl, Johannes A Langendijk, Aart A van 't Veld, Roel J H M Steenbakkers, Erik W Korevaar

Onderzoeksoutput: ArticleAcademicpeer review

Uittreksel

OBJECTIVES: To demonstrate that novice dosimetry planners efficiently create clinically acceptable IMRT plans for head and neck cancer (HNC) patients using a commercially available multicriteria optimization (MCO) system.

METHODS: Twenty HNC patients were enrolled in this in-silico comparative planning study. Per patient, novice planners with less experience in dosimetry planning created an IMRT plan using an MCO system (RayStation). Furthermore, a conventionally planned clinical IMRT plan was available (Pinnacle(3)). All conventional IMRT and MCO-plans were blind-rated by two expert radiation-oncologists in HNC, using a 5-point scale (1-5 with 5 the highest score) assessment form comprising 10 questions. Additionally, plan quality was reported in terms of planning time, dosimetric and normal tissue complication probability (NTCP) comparisons. Inter-rater reliability was derived using the intra-class correlation coefficient (ICC).

RESULTS: In total, the radiation-oncologists rated 800 items on plan quality. The overall plan score indicated no differences between both planning techniques (conventional IMRT: 3.8 ± 1.2 vs. MCO: 3.6 ± 1.1, p = 0.29). The inter-rater reliability of all ratings was 0.65 (95% CI: 0.57-0.71), indicating substantial agreement between the radiation-oncologists. In 93% of cases, the scoring difference of the conventional IMRT and MCO-plans was one point or less. Furthermore, MCO-plans led to slightly higher dose uniformity in the therapeutic planning target volume, to a lower integral body dose (13.9 ± 4.5 Gy vs. 12.9 ± 4.0 Gy, p < 0.001), and to reduced dose to the contra-lateral parotid gland (28.1 ± 11.8 Gy vs. 23.0 ± 11.2 Gy, p < 0.002). Consequently, NTCP estimates for xerostomia reduced by 8.4 ± 7.4% (p < 0.003). The hands-on time of the conventional IMRT planning was approximately 205 min. The time to create an MCO-plan was on average 43 ± 12 min.

CONCLUSIONS: MCO planning enables novice treatment planners to create high quality IMRT plans for HNC patients. Plans were created with vastly reduced planning times, requiring less resources and a short learning curve.

Originele taal-2English
TijdschriftRadiation oncology
Volume10
Nummer van het tijdschrift87
DOI's
StatusPublished - 12 apr 2015

Keywords

  • bejaard
  • algoritmen
  • carcinoma, squamous cel
  • computersimulatie
  • vrouwelijk
  • hoofd en nek neoplasma's
  • mensen
  • mannelijk
  • middelbaar
  • prospectieve studies
  • kwaliteitsborg, gezondheid
  • radiometrie
  • radiotherapie dosering
  • radiotherapie, planning, computergesteund
  • radiotherapie, intensiteit gemoduleerd
  • tijdschriftartikel

Citeer dit

Kierkels, Roel G J ; Visser, Ruurd ; Bijl, Hendrik P ; Langendijk, Johannes A ; van 't Veld, Aart A ; Steenbakkers, Roel J H M ; Korevaar, Erik W. / Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy. In: Radiation oncology . 2015 ; Vol. 10, Nr. 87.
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title = "Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy",
abstract = "OBJECTIVES: To demonstrate that novice dosimetry planners efficiently create clinically acceptable IMRT plans for head and neck cancer (HNC) patients using a commercially available multicriteria optimization (MCO) system.METHODS: Twenty HNC patients were enrolled in this in-silico comparative planning study. Per patient, novice planners with less experience in dosimetry planning created an IMRT plan using an MCO system (RayStation). Furthermore, a conventionally planned clinical IMRT plan was available (Pinnacle(3)). All conventional IMRT and MCO-plans were blind-rated by two expert radiation-oncologists in HNC, using a 5-point scale (1-5 with 5 the highest score) assessment form comprising 10 questions. Additionally, plan quality was reported in terms of planning time, dosimetric and normal tissue complication probability (NTCP) comparisons. Inter-rater reliability was derived using the intra-class correlation coefficient (ICC).RESULTS: In total, the radiation-oncologists rated 800 items on plan quality. The overall plan score indicated no differences between both planning techniques (conventional IMRT: 3.8 ± 1.2 vs. MCO: 3.6 ± 1.1, p = 0.29). The inter-rater reliability of all ratings was 0.65 (95{\%} CI: 0.57-0.71), indicating substantial agreement between the radiation-oncologists. In 93{\%} of cases, the scoring difference of the conventional IMRT and MCO-plans was one point or less. Furthermore, MCO-plans led to slightly higher dose uniformity in the therapeutic planning target volume, to a lower integral body dose (13.9 ± 4.5 Gy vs. 12.9 ± 4.0 Gy, p < 0.001), and to reduced dose to the contra-lateral parotid gland (28.1 ± 11.8 Gy vs. 23.0 ± 11.2 Gy, p < 0.002). Consequently, NTCP estimates for xerostomia reduced by 8.4 ± 7.4{\%} (p < 0.003). The hands-on time of the conventional IMRT planning was approximately 205 min. The time to create an MCO-plan was on average 43 ± 12 min.CONCLUSIONS: MCO planning enables novice treatment planners to create high quality IMRT plans for HNC patients. Plans were created with vastly reduced planning times, requiring less resources and a short learning curve.",
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author = "Kierkels, {Roel G J} and Ruurd Visser and Bijl, {Hendrik P} and Langendijk, {Johannes A} and {van 't Veld}, {Aart A} and Steenbakkers, {Roel J H M} and Korevaar, {Erik W}",
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Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy. / Kierkels, Roel G J; Visser, Ruurd; Bijl, Hendrik P; Langendijk, Johannes A; van 't Veld, Aart A; Steenbakkers, Roel J H M; Korevaar, Erik W.

In: Radiation oncology , Vol. 10, Nr. 87, 12.04.2015.

Onderzoeksoutput: ArticleAcademicpeer review

TY - JOUR

T1 - Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy

AU - Kierkels, Roel G J

AU - Visser, Ruurd

AU - Bijl, Hendrik P

AU - Langendijk, Johannes A

AU - van 't Veld, Aart A

AU - Steenbakkers, Roel J H M

AU - Korevaar, Erik W

PY - 2015/4/12

Y1 - 2015/4/12

N2 - OBJECTIVES: To demonstrate that novice dosimetry planners efficiently create clinically acceptable IMRT plans for head and neck cancer (HNC) patients using a commercially available multicriteria optimization (MCO) system.METHODS: Twenty HNC patients were enrolled in this in-silico comparative planning study. Per patient, novice planners with less experience in dosimetry planning created an IMRT plan using an MCO system (RayStation). Furthermore, a conventionally planned clinical IMRT plan was available (Pinnacle(3)). All conventional IMRT and MCO-plans were blind-rated by two expert radiation-oncologists in HNC, using a 5-point scale (1-5 with 5 the highest score) assessment form comprising 10 questions. Additionally, plan quality was reported in terms of planning time, dosimetric and normal tissue complication probability (NTCP) comparisons. Inter-rater reliability was derived using the intra-class correlation coefficient (ICC).RESULTS: In total, the radiation-oncologists rated 800 items on plan quality. The overall plan score indicated no differences between both planning techniques (conventional IMRT: 3.8 ± 1.2 vs. MCO: 3.6 ± 1.1, p = 0.29). The inter-rater reliability of all ratings was 0.65 (95% CI: 0.57-0.71), indicating substantial agreement between the radiation-oncologists. In 93% of cases, the scoring difference of the conventional IMRT and MCO-plans was one point or less. Furthermore, MCO-plans led to slightly higher dose uniformity in the therapeutic planning target volume, to a lower integral body dose (13.9 ± 4.5 Gy vs. 12.9 ± 4.0 Gy, p < 0.001), and to reduced dose to the contra-lateral parotid gland (28.1 ± 11.8 Gy vs. 23.0 ± 11.2 Gy, p < 0.002). Consequently, NTCP estimates for xerostomia reduced by 8.4 ± 7.4% (p < 0.003). The hands-on time of the conventional IMRT planning was approximately 205 min. The time to create an MCO-plan was on average 43 ± 12 min.CONCLUSIONS: MCO planning enables novice treatment planners to create high quality IMRT plans for HNC patients. Plans were created with vastly reduced planning times, requiring less resources and a short learning curve.

AB - OBJECTIVES: To demonstrate that novice dosimetry planners efficiently create clinically acceptable IMRT plans for head and neck cancer (HNC) patients using a commercially available multicriteria optimization (MCO) system.METHODS: Twenty HNC patients were enrolled in this in-silico comparative planning study. Per patient, novice planners with less experience in dosimetry planning created an IMRT plan using an MCO system (RayStation). Furthermore, a conventionally planned clinical IMRT plan was available (Pinnacle(3)). All conventional IMRT and MCO-plans were blind-rated by two expert radiation-oncologists in HNC, using a 5-point scale (1-5 with 5 the highest score) assessment form comprising 10 questions. Additionally, plan quality was reported in terms of planning time, dosimetric and normal tissue complication probability (NTCP) comparisons. Inter-rater reliability was derived using the intra-class correlation coefficient (ICC).RESULTS: In total, the radiation-oncologists rated 800 items on plan quality. The overall plan score indicated no differences between both planning techniques (conventional IMRT: 3.8 ± 1.2 vs. MCO: 3.6 ± 1.1, p = 0.29). The inter-rater reliability of all ratings was 0.65 (95% CI: 0.57-0.71), indicating substantial agreement between the radiation-oncologists. In 93% of cases, the scoring difference of the conventional IMRT and MCO-plans was one point or less. Furthermore, MCO-plans led to slightly higher dose uniformity in the therapeutic planning target volume, to a lower integral body dose (13.9 ± 4.5 Gy vs. 12.9 ± 4.0 Gy, p < 0.001), and to reduced dose to the contra-lateral parotid gland (28.1 ± 11.8 Gy vs. 23.0 ± 11.2 Gy, p < 0.002). Consequently, NTCP estimates for xerostomia reduced by 8.4 ± 7.4% (p < 0.003). The hands-on time of the conventional IMRT planning was approximately 205 min. The time to create an MCO-plan was on average 43 ± 12 min.CONCLUSIONS: MCO planning enables novice treatment planners to create high quality IMRT plans for HNC patients. Plans were created with vastly reduced planning times, requiring less resources and a short learning curve.

KW - aged

KW - algorithms

KW - carcinoma, squamous cell

KW - computer simulation

KW - head and neck neoplasms

KW - humans

KW - prospective studies

KW - quality assurance, health care

KW - radiometry

KW - radiotherapy dosage

KW - radiotherapy planning, computer-assisted

KW - radiotherapy, intensity-modulated

KW - bejaard

KW - algoritmen

KW - carcinoma, squamous cel

KW - computersimulatie

KW - vrouwelijk

KW - hoofd en nek neoplasma's

KW - mensen

KW - mannelijk

KW - middelbaar

KW - prospectieve studies

KW - kwaliteitsborg, gezondheid

KW - radiometrie

KW - radiotherapie dosering

KW - radiotherapie, planning, computergesteund

KW - radiotherapie, intensiteit gemoduleerd

KW - tijdschriftartikel

UR - http://www.mendeley.com/research/multicriteria-optimization-enables-less-experienced-planners-efficiently-produce-high-quality-treatm

U2 - 10.1186/s13014-015-0385-9

DO - 10.1186/s13014-015-0385-9

M3 - Article

VL - 10

JO - Radiation oncology

JF - Radiation oncology

SN - 1748-717X

IS - 87

ER -