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Automated Treatment Plan Integrity Verification for Proton Therapy: Enhancing Error Detection and Workflow

Jiyeon Park^1,2, Emily Feldman¹, Mark Artz^1,2

¹University of Florida Health Proton Therapy Institute, Jacksonville, FL, USA.

International Journal of Particle Therapy

|October 27, 2025

Summary

This summary is machine-generated.

This study introduces Auto-IniCheck, an automated proton therapy plan review system. It significantly enhances efficiency and safety by automating 60-65% of checks, reducing review time and risk.

Keywords:

Incident learning Medical errors Plan review Proton therapy Quality assurance

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Area of Science:

Medical Physics
Radiation Oncology
Quality Assurance

Background:

Automatic error detection in radiation therapy predominantly focuses on photon therapy, neglecting proton therapy.
Proton therapy offers advantages but requires robust quality assurance for its complex delivery techniques like pencil-beam scanning.

Purpose of the Study:

To develop and validate an automated framework, Auto-IniCheck, for initial proton therapy plan review.
To improve error detection capabilities and workflow efficiency in pencil-beam scanning proton therapy.

Main Methods:

Designed Auto-IniCheck following AAPM TG-275 guidelines for systematic physics plan integrity verification.
Integrated site- and modality-specific checklists into a process map with color-coded risk levels.
Utilized failure modes and effects analysis to determine risk levels and assessed efficiency via risk priority number reduction.

Main Results:

Auto-IniCheck automated 60-65% of checklist items, reducing plan review time to under 10 seconds.
Achieved an average 65% risk priority number reduction, reclassifying 15 high-risk items to low risk.
Demonstrated greatest risk reduction (75%) in robustness optimization, couch confirmation, and target validation.

Conclusions:

Auto-IniCheck streamlines proton therapy plan reviews, enhancing both efficiency and safety.
The automated system proactively addresses proton-specific failure modes for practical initial plan review.
Offers a scalable solution for maintaining rigorous quality assurance as proton therapy programs expand.