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DJR 47-1A: Fully automated planning and delivery of hippocampal-sparing whole brain irradiation

Course Details

MDCB Credits: 2.50

ARRT Credits: 1.00

Available Until: 3/31/2023

Non-Member Price: $87.50

Member Price: $50.00

Member PLUS Price: $50.00

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Authors: Iris Rusu, M.S. , John Roeske, Ph.D. , Abhishek Solanki, M.D. , Hyejoo Kang, Ph.D

Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL, 60153 USA
Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardine Cancer Center, Loyola University Chicago, Maywood, IL, 60153 USA

The goal of this study is to fully automate the treatment planning and delivery process of hippocampal-sparing whole-brain irradiation (HS-WBRT) by combining a RapidPlan (RP) knowledge-based planning model and  HyperArc  (HA)  technology.  Additionally,  this study compares the dosimetric performance of RapidPlan-HyperArc (RP-HA) treatment plans with RP plans and volumetric modulated arc therapy (VMAT) plans.

Ten patients previously treated with HS-WBRT using conventional VMAT were re-planned using RP- HA technique and RP model for HS-WBRT. Treatment plans were generated for 30Gy in 3Gy fractions using 6MV photon beam on a TrueBeam linear accelerator (Varian Medical Systems, Palo Alto, CA) equipped with high definition multileaf collimator (HDMLC). Target coverage, homogeneity index (HI), Paddick Conformity index (CI), dose to organs-at-risk (OARs) provided by the 3 planning modalities were compared, and a paired t-test was performed. Total number of monitor units (MU), effective planning time and beam-on-time time were reported and evaluated for each plan.

RP-HA plans achieved on average a 4% increase in D98% of PTV, a 26% improvement in HI, a 2.3% increase in CI, when compared to RP plans. Furthermore, RP-HA plans provided on average 11% decrease in D100% of hippocampi when compared to VMAT plans. All RP-HA plans were generated in less than 30 minutes while RP plans took 40 minutes and VMAT plans required on average 9 hours to complete. Regarding beam-on-time time, it was estimated that RP-HA plans take on average 5 minutes to deliver while RP and VMAT plans require 6.5 and 10 minutes, respectively.

RP-HA method provides fully automated planning and delivery for HS-WBRT. The auto-generated plans together with automated treatment delivery allow standardization of plan quality, increased efficiency and ultimately improved patient care.

As of January 1, 2022, ARRT requires CE Credits for Directed Journal Readings to be based on the word count for each article. So, the number of CE Credits for each DJR article will vary for ARRT. For this article, the ARRT CE Credit will be 1 Credit. The MDCB CE Credits will remain at 2.5 Credits. 

ARRT CQR Credit Distribution
Radiation Therapy 2017:
 Prescription and Dose Calculation = 1.00 credits
Radiation Therapy 2022:
 Prescription and Dose Calculation = 1.00 credits