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Related Experiment Video

Updated: Sep 18, 2025

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

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Published on: April 11, 2018

Exploring plan quality: using plan complexity to quantitatively analyse the tradeoff between clinical suitability and

S Cavinato¹, A G Amico¹, A Bettinelli¹

¹Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)

|June 22, 2025

Summary

Controlling Volumetric Modulated Arc Therapy (VMAT) plan complexity improves accuracy but may slightly reduce clinical suitability. An aggregate complexity score helps balance these factors for better radiation therapy outcomes.

Keywords:

Dosimetric accuracy PSQA Plan complexity Plan quality

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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Published on: February 6, 2019

Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Planning

Background:

Volumetric Modulated Arc Therapy (VMAT) is a complex radiotherapy technique.
Balancing plan complexity with clinical suitability and dosimetric accuracy is crucial for VMAT optimization.

Purpose of the Study:

To quantitatively investigate the trade-off between clinical suitability and dosimetric accuracy by controlling VMAT plan complexity.
To establish methods for assessing and managing VMAT plan complexity.

Main Methods:

Re-optimized 30 VMAT plans with varying complexity constraints using Monitor Units (MU) and Aperture Shape Controller (ASC).
Evaluated plans using complexity metrics, gamma-index (γ-index) passing rate for dosimetric accuracy, and Adjusted Plan Quality Metric (APQM%) for clinical suitability.

Main Results:

Reduced plan complexity enhanced dosimetric accuracy (higher γ-index) but moderately decreased clinical suitability (lower APQM%).
MLC aperture complexity metrics were key indicators of accuracy and suitability.
An aggregate complexity score effectively characterized the trade-off between accuracy and suitability.

Conclusions:

Managing VMAT plan complexity using defined proxies can quantitatively balance clinical suitability and deliverability.
This approach offers potential for standardizing VMAT plan quality assessment and improving treatment outcomes.
The findings contribute to more consistent and effective evaluation of overall radiotherapy plan quality.