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Related Experiment Video

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Radiotherapy plan evaluation indices: A dosimetrical suitability check.

Ganeshkumar Patel1, Abhijit Mandal1, Ravindra Shende2

  • 1Department of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Journal of Cancer Research and Therapeutics
|June 14, 2021
PubMed
Summary

This study evaluated plan evaluation indices for radiation therapy, finding that Conformity Index (CI) formulas incorporating organs at risk (OARs) are more reliable. Sigma index effectively measures dose homogeneity, especially when OARs are excluded from optimization.

Keywords:
Conformity indexhomogeneity indexplanning target volume

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Treatment Planning

Background:

  • Accurate evaluation of radiation therapy treatment plans is crucial for optimizing clinical outcomes.
  • Existing plan evaluation indices, such as Conformity Index (CI) and Homogeneity Index (HI), vary in their ability to reflect plan quality.
  • The impact of including or excluding organs at risk (OARs) during optimization on these indices requires further investigation.

Purpose of the Study:

  • To classify and compare the dosimetric suitability of various available plan evaluation indices.
  • To assess the reliability of different Conformity Index (CI) formulas, particularly those that account for critical structures.
  • To evaluate the performance of Homogeneity Index (HI) formulas in differentiating treatment plan scenarios.

Main Methods:

  • Published plan evaluation indices were categorized based on their consideration of critical structures and target volume coverage.
  • Two types of Volumetric Arc Therapy (V.A.T.) plans were generated for 25 patients: Plan-A (including OARs objectives) and Plan-B (excluding OARs objectives).
  • Planning evaluation parameters, including CI and HI, were calculated and compared between Plan-A and Plan-B.

Main Results:

  • Conformity Index (CI) calculations showed less than 2% variation across different formulas and scenarios, failing to distinguish between planning situations.
  • While most Homogeneity Index (HI) formulas showed negligible variation, the S-index and HI (D) exhibited marginal differences.
  • Excluding OARs from optimization improved dose homogeneity, a finding particularly highlighted by the sigma index formula.

Conclusions:

  • Conformity Index (CI) formulas that incorporate organs at risk (OARs) demonstrate greater reliability in treatment plan evaluation.
  • The sigma index is identified as a more efficient and sensitive formula for assessing dose homogeneity in treatment plans, especially when OARs are not optimized.
  • These findings can inform the selection of appropriate indices for robust treatment plan quality assurance in radiation oncology.