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Related Experiment Video

Updated: May 3, 2026

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Plan complexity metrics for head and neck VMAT competition plans.

Hiroyuki Okamoto¹, Akihisa Wakita², Kensuke Tani²

¹Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku Tokyo, 104-0045, Japan.

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists

|February 17, 2024

Summary

Plan complexity metrics (PCMs) in head and neck (HN) volumetric modulated arc therapy (VMAT) competition plans were evaluated against clinical plans. Competition plans were found realistic and reasonable from a quality assurance perspective, informing future plan evaluations.

Keywords:

Plan competition Plan complexity Plan quality Pretreatment QA VMAT

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Area of Science:

Medical Physics
Radiation Oncology
Radiotherapy Planning

Background:

Previous radiotherapy plan competitions focused on dose metrics, neglecting plan realism and quality assurance (QA).
Assessing plan complexity metrics (PCMs) in volumetric modulated arc therapy (VMAT) competition plans is crucial for understanding their clinical relevance.

Purpose of the Study:

To investigate the relationship between PCMs in VMAT competition plans and clinically accepted treatment plans verified by patient-specific QA (PSQA).
To examine the association of PCMs with overall plan quality, specifically dose distribution quality.

Main Methods:

A head and neck (HN) VMAT plan competition in Japan provided 210 competition plans.
Dose distribution quality was assessed using dose-volume histogram (DVH) metrics and a dose distribution plan score (DDPS).
PCMs of competition plans were compared with clinically accepted HN VMAT plans undergoing PSQA.

Main Results:

The mean DDPS for competition plans was 158.5 ± 20.6, with weak correlations observed between DDPS and most PCMs.
Significant differences in PCMs were noted between high-DDPS plans and others, indicating complexity increases with quality.
PCMs of competition plans showed similar distributions to clinical plans, suggesting comparable planning skills and variability.

Conclusions:

Submitted HN VMAT competition plans are realistic and reasonable from a QA standpoint when compared to clinical plans.
Plan complexity in HN VMAT competition plans correlates with improved dose distribution quality.
This study provides a potential framework for evaluating plan quality in future radiotherapy plan competitions.