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A Step Toward Making VMAT TBI More Prevalent: Automating the Treatment Planning Process.

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Automated total body irradiation (TBI) planning using volumetric modulated arc therapy (VMAT) significantly reduced planning time and improved lung sparing. Developed scripts offer superior VMAT TBI access for institutions.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Total body irradiation (TBI) is a crucial radiotherapy technique.
  • Manual treatment planning for TBI using volumetric modulated arc therapy (VMAT) is time-consuming.
  • Automation of VMAT TBI planning can potentially improve efficiency and consistency.

Purpose of the Study:

  • To develop and evaluate an automated treatment planning process for VMAT TBI.
  • To compare the quality and efficiency of automated plans versus manually generated plans.

Main Methods:

  • Development of two scripts: one for automation of structure creation and plan generation, and another for successive optimizations.
  • Evaluation of the autoplanning process on ten previously treated VMAT TBI patients.
  • Comparison of dosimetric indices using paired t tests and blinded physician review.

Main Results:

  • Autoplans showed no significant differences in global Dmax, planning target volume V110%, kidney Dmean, or bowel Dmax compared to manual plans.
  • Autoplans achieved significant decreases in Dmean to the lungs and lungs-1cm (5.4% and 6.8% reduction, respectively).
  • Physicians preferred autoplans 77% of the time, and planning time was reduced from 2-3 days to 3-5 hours.

Conclusions:

  • Automated VMAT TBI planning significantly reduces planning time without compromising plan quality.
  • Autoplans offer superior lung sparing while maintaining target coverage and similar global Dmax.
  • The open-source availability of the developed scripts promotes wider adoption of VMAT TBI planning.