
Inverse treatment planning for spinal robotic radiosurgery: an international multi‐institutional benchmark trial
Author(s) -
Blanck Oliver,
Wang Lei,
Baus Wolfgang,
Grimm Jimm,
Lacornerie Thomas,
Nilsson Joakim,
Luchkovskyi Sergii,
Cano Isabel Palazon,
Shou Zhenyu,
Ayadi Myriam,
Treuer Harald,
Viard Romain,
Siebert FrankAndre,
Chan Mark K.H.,
Hildebrandt Guido,
Dunst Jürgen,
Imhoff Detlef,
Wurster Stefan,
Wolff Robert,
Romanelli Pantaleo,
Lartigau Eric,
Semrau Robert,
Soltys Scott G.,
Schweikard Achim
Publication year - 2016
Publication title -
journal of applied clinical medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 48
ISSN - 1526-9914
DOI - 10.1120/jacmp.v17i3.6151
Subject(s) - radiosurgery , radiation treatment planning , benchmark (surveying) , computer science , ranking (information retrieval) , medical physics , medicine , quality assurance , radiation therapy , artificial intelligence , radiology , external quality assessment , geodesy , pathology , geography
Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high‐dose radiation to well‐defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user‐dependent. We performed an international, multi‐institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex‐shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord ( V 14 Gy < 2 cc ,V 18 Gy < 0.1 cc ) and target (coverage > 95 % ). The resulting plans were rated on a scale from 1 to 4 (excellent‐poor) in five categories (constraint compliance, optimization goals, low‐dose regions, ITP complexity, and clinical acceptability) by a blinded review panel. Additionally, the plans were mathematically rated based on plan indices (critical structure and target doses, conformity, monitor units, normal tissue complication probability, and treatment time) and compared to the human rankings. The treatment plans and the reviewers' rankings varied substantially among the participating centers. The average mean overall rank was 2.4 (1.2‐4.0) and 8/10 plans were rated excellent in at least one category by at least one reviewer. The mathematical rankings agreed with the mean overall human rankings in 9/10 cases pointing toward the possibility for sole mathematical plan quality comparison. The final rankings revealed that a plan with a well‐balanced trade‐off among all planning objectives was preferred for treatment by most participants, reviewers, and the mathematical ranking system. Furthermore, this plan was generated with simple planning techniques. Our multi‐institutional planning study found wide variability in ITP approaches for spinal robotic radiosurgery. The participants', reviewers', and mathematical match on preferable treatment plans and ITP techniques indicate that agreement on treatment planning and plan quality can be reached for spinal robotic radiosurgery. PACS number(s): 87.55.de