<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Craniospinal irradiation (CSI) poses a challenge to treatment planning due to the large target, field junction, and multiple organs at risk (OARs) involved. The aim of this study was to evaluate the performance of knowledge-based planning (KBP) in CSI by comparing original manual plans (MP), KBP RapidPlan initial plans (RP<sub>I</sub>), and KBP RapidPlan final plans (RP<sub>F</sub>), which received further re-optimization to meet the dose constraints.</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>Dose distributions in the target were evaluated in terms of coverage, mean dose, conformity index (CI), and homogeneity index (HI). The dosimetric results of OARs, planning time, and monitor unit (MU) were evaluated.</p>
</sec>
<sec><h3>Results</h3>
<p>All MP and RP<sub>F</sub> plans met the plan goals, and 89.36% of RP<sub>I</sub> plans met the plan goals. The Wilcoxon tests showed comparable target coverage, CI, and HI for the MP and RP<sub>F</sub> groups; however, worst plan quality was demonstrated in the RP<sub>I</sub> plans than in MP and RP<sub>F</sub>. For the OARs, RP<sub>F</sub> and RP<sub>I</sub> groups had better dosimetric results than the MP group (<italic>P</italic> &lt; 0.05 for optic nerves, eyes, parotid glands, and heart). The planning time was significantly reduced by the KBP from an average of 677.80 min in MP to 227.66 min (<italic>P</italic> &lt; 0.05) and 307.76 min (<italic>P</italic> &lt; 0.05) in RP<sub>I</sub>, and RP<sub>F</sub>, respectively. MU was not significantly different between these three groups.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>The KBP can significantly reduce planning time in CSI. Manual re-optimization after the initial KBP is recommended to enhance the plan quality.</p>
</sec>
</abstract>

Background
Craniospinal irradiation (CSI) poses a challenge to treatment planning due to the large target, field junction, and multiple organs at risk (OARs) involved. The aim of this study was to evaluate the performance of knowledge-based planning (KBP) in CSI by comparing original manual plans (MP), KBP RapidPlan initial plans (RPI), and KBP RapidPlan final plans (RPF), which received further re-optimization to meet the dose constraints.

Patients and methods
Dose distributions in the target were evaluated in terms of coverage, mean dose, conformity index (CI), and homogeneity index (HI). The dosimetric results of OARs, planning time, and monitor unit (MU) were evaluated.

Results
All MP and RPF plans met the plan goals, and 89.36% of RPI plans met the plan goals. The Wilcoxon tests showed comparable target coverage, CI, and HI for the MP and RPF groups; however, worst plan quality was demonstrated in the RPI plans than in MP and RPF. For the OARs, RPF and RPI groups had better dosimetric results than the MP group (P < 0.05 for optic nerves, eyes, parotid glands, and heart). The planning time was significantly reduced by the KBP from an average of 677.80 min in MP to 227.66 min (P < 0.05) and 307.76 min (P < 0.05) in RPI, and RPF, respectively. MU was not significantly different between these three groups.

Conclusions
The KBP can significantly reduce planning time in CSI. Manual re-optimization after the initial KBP is recommended to enhance the plan quality.

Dosimetry and efficiency comparison of knowledge-based and manual planning using volumetric modulated arc therapy for craniospinal irradiation

Department of Biomedical Imaging and Radiological Sciences

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Craniospinal irradiation (CSI) poses a challenge to treatment planning due to the large target, field junction, and multiple organs at risk (OARs)...

Dosimetry and efficiency comparison of knowledge-based and manual planning using volumetric modulated arc therapy for craniospinal irradiation

Article Category: Research Article

Publicado en línea: 07 mar 2024

Páginas: 289 - 299

Recibido: 04 nov 2023

Aceptado: 03 ene 2024

DOI: https://doi.org/10.2478/raon-2024-0018

Palabras clave
knowledge-based planning, RapidPlan, craniospinal irradiation, volumetric modulated arc therapy

© 2024 Wei-Ta Tsai et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Dosimetry and efficiency comparison of knowledge-based and manual planning using volumetric modulated arc therapy for craniospinal irradiation

Article Category: Research Article

Publicado en línea: 07 mar 2024

Páginas: 289 - 299

Recibido: 04 nov 2023

Aceptado: 03 ene 2024

DOI: https://doi.org/10.2478/raon-2024-0018

Palabras claveknowledge-based planning, RapidPlan, craniospinal irradiation, volumetric modulated arc therapy

© 2024 Wei-Ta Tsai et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Palabras clave
knowledge-based planning, RapidPlan, craniospinal irradiation, volumetric modulated arc therapy