Automated treatment planning for brain and spinal metastases

Automation improves workflow efficiency in treatment planning, especially for urgent spinal and cerebral cases. This study develops an automated planning approach for brain and spinal metastases using the Eclipse Scripting API.

A retrospective analysis was conducted on 82 patients with spinal metastases and 93 with brain metastases. For spinal metastases, three beam arrangements were tested. For whole-brain radiation therapy (WBRT), the algorithm optimized gantry angles by identifying the largest intersection of the eyes' projections in the beam's eye view (BEV), within specified angular intervals. To reduce radiation exposure to the lenses, the algorithm automatically set the fluence to zero within the BEV lens contours, applying a 3 mm margin. Dosimetric analysis assessed dose constraints, and the time required for plan generation was recorded.

The median planning target volume (PTV) V99 parameter for WBRT was 97.6%, while for spinal vertebrae irradiation, it ranged from 95.9% to 98.8%. Regarding the clinical target volume (CTV), the median V99 parameter for WBRT was 99.1%, and for spinal vertebrae, it was 100%. The maximum point doses for these sites were recorded at 106.2% and 106.3%, respectively. WBRT plan generation required an average of 8 minutes ± 2 minutes and 10 seconds, whereas for spinal vertebrae irradiation, it ranged from 5 minutes and 45 seconds ± 1 minute and 43 seconds to 6 minutes and 10 seconds ± 1 minute and 45 seconds.

This study demonstrates that the developed algorithms for treatment planning can efficiently generate high-quality treatment plans for both sites within a short timeframe.