TY - JOUR
T1 - Treatment planning for spinal radiosurgery
T2 - A competitive multiplatform benchmark challenge
AU - Moustakis, Christos
AU - Chan, Mark K.H.
AU - Kim, Jinkoo
AU - Nilsson, Joakim
AU - Bergman, Alanah
AU - Bichay, Tewfik J.
AU - Palazon Cano, Isabel
AU - Cilla, Savino
AU - Deodato, Francesco
AU - Doro, Raffaela
AU - Dunst, Jürgen
AU - Eich, Hans Theodor
AU - Fau, Pierre
AU - Fong, Ming
AU - Haverkamp, Uwe
AU - Heinze, Simon
AU - Hildebrandt, Guido
AU - Imhoff, Detlef
AU - de Klerck, Erik
AU - Köhn, Janett
AU - Lambrecht, Ulrike
AU - Loutfi-Krauss, Britta
AU - Ebrahimi, Fatemeh
AU - Masi, Laura
AU - Mayville, Alan H.
AU - Mestrovic, Ante
AU - Milder, Maaike
AU - Morganti, Alessio G.
AU - Rades, Dirk
AU - Ramm, Ulla
AU - Rödel, Claus
AU - Siebert, Frank Andre
AU - den Toom, Wilhelm
AU - Wang, Lei
AU - Wurster, Stefan
AU - Schweikard, Achim
AU - Soltys, Scott G.
AU - Ryu, Samuel
AU - Blanck, Oliver
N1 - Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose: To investigate the quality of treatment plans of spinal radiosurgery derived from different planning and delivery systems. The comparisons include robotic delivery and intensity modulated arc therapy (IMAT) approaches. Multiple centers with equal systems were used to reduce a bias based on individual’s planning abilities. The study used a series of three complex spine lesions to maximize the difference in plan quality among the various approaches. Methods: Internationally recognized experts in the field of treatment planning and spinal radiosurgery from 12 centers with various treatment planning systems participated. For a complex spinal lesion, the results were compared against a previously published benchmark plan derived for CyberKnife radiosurgery (CKRS) using circular cones only. For two additional cases, one with multiple small lesions infiltrating three vertebrae and a single vertebra lesion treated with integrated boost, the results were compared against a benchmark plan generated using a best practice guideline for CKRS. All plans were rated based on a previously established ranking system. Results: All 12 centers could reach equality (n = 4) or outperform (n = 8) the benchmark plan. For the multiple lesions and the single vertebra lesion plan only 5 and 3 of the 12 centers, respectively, reached equality or outperformed the best practice benchmark plan. However, the absolute differences in target and critical structure dosimetry were small and strongly planner-dependent rather than system-dependent. Overall, gantry-based IMAT with simple planning techniques (two coplanar arcs) produced faster treatments and significantly outperformed static gantry intensity modulated radiation therapy (IMRT) and multileaf collimator (MLC) or non-MLC CKRS treatment plan quality regardless of the system (mean rank out of 4 was 1.2 vs. 3.1, p = 0.002). Conclusions: High plan quality for complex spinal radiosurgery was achieved among all systems and all participating centers in this planning challenge. This study concludes that simple IMAT techniques can generate significantly better plan quality compared to previous established CKRS benchmarks.
AB - Purpose: To investigate the quality of treatment plans of spinal radiosurgery derived from different planning and delivery systems. The comparisons include robotic delivery and intensity modulated arc therapy (IMAT) approaches. Multiple centers with equal systems were used to reduce a bias based on individual’s planning abilities. The study used a series of three complex spine lesions to maximize the difference in plan quality among the various approaches. Methods: Internationally recognized experts in the field of treatment planning and spinal radiosurgery from 12 centers with various treatment planning systems participated. For a complex spinal lesion, the results were compared against a previously published benchmark plan derived for CyberKnife radiosurgery (CKRS) using circular cones only. For two additional cases, one with multiple small lesions infiltrating three vertebrae and a single vertebra lesion treated with integrated boost, the results were compared against a benchmark plan generated using a best practice guideline for CKRS. All plans were rated based on a previously established ranking system. Results: All 12 centers could reach equality (n = 4) or outperform (n = 8) the benchmark plan. For the multiple lesions and the single vertebra lesion plan only 5 and 3 of the 12 centers, respectively, reached equality or outperformed the best practice benchmark plan. However, the absolute differences in target and critical structure dosimetry were small and strongly planner-dependent rather than system-dependent. Overall, gantry-based IMAT with simple planning techniques (two coplanar arcs) produced faster treatments and significantly outperformed static gantry intensity modulated radiation therapy (IMRT) and multileaf collimator (MLC) or non-MLC CKRS treatment plan quality regardless of the system (mean rank out of 4 was 1.2 vs. 3.1, p = 0.002). Conclusions: High plan quality for complex spinal radiosurgery was achieved among all systems and all participating centers in this planning challenge. This study concludes that simple IMAT techniques can generate significantly better plan quality compared to previous established CKRS benchmarks.
KW - Benchmark study
KW - Multicenter
KW - Multiplatform
KW - Spinal radiosurgery
KW - Stereotactic body radiation therapy
KW - Treatment planning challenge
UR - https://www.scopus.com/pages/publications/85047430752
U2 - 10.1007/s00066-018-1314-2
DO - 10.1007/s00066-018-1314-2
M3 - Article
C2 - 29802435
AN - SCOPUS:85047430752
SN - 0179-7158
VL - 194
SP - 843
EP - 854
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 9
ER -