First system for fully-automated multi-criterial treatment planning for a high-magnetic field MR-Linac applied to rectal cancer.

Background and purpose: In this study we developed a workflow for fully-automated generation of deliverable IMRT plans for a 1.5 T MR-Linac (MRL) based on contoured CT scans, and we evaluated automated MRL planning for rectal cancer. Methods: The Monte Carlo dose calculation engine used in the clini...

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Published in:Acta Oncologica Vol. 59; no. 8; pp. 926 - 933
Main Authors: Bijman, Rik, Rossi, Linda, Janssen, Tomas, de Ruiter, Peter, Carbaat, Casper, van Triest, Baukelien, Breedveld, Sebastiaan, Sonke, Jan-Jakob, Heijmen, Ben
Format: diagnostic images research tables/charts Journal Article
Published: Medical Journals Sweden AB Aug2020
Online Access:View this record in EBSCOhost
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      dt: Aug2020
      vid: 59
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      pub: Medical Journals Sweden AB
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        10.1080/0284186X.2020.1766697
        144826827
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        atl: First system for fully-automated multi-criterial treatment planning for a high-magnetic field MR-Linac applied to rectal cancer.
      aug:
        au:
          Bijman, Rik
          Rossi, Linda
          Janssen, Tomas
          de Ruiter, Peter
          Carbaat, Casper
          van Triest, Baukelien
          Breedveld, Sebastiaan
          Sonke, Jan-Jakob
          Heijmen, Ben
        affil: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
      sug:
        subj:
          Radiotherapy, Conformal
          Rectal Neoplasms Radiotherapy
          Automation
          Radiation Dosage
          Dosage Calculation
          Tomography, X-Ray Computed
          Rectal Neoplasms Radiography
          Human
          Workload
          Dosimetry
          Workflow
      ab: Background and purpose: In this study we developed a workflow for fully-automated generation of deliverable IMRT plans for a 1.5 T MR-Linac (MRL) based on contoured CT scans, and we evaluated automated MRL planning for rectal cancer. Methods: The Monte Carlo dose calculation engine used in the clinical MRL TPS (Monaco, Elekta AB, Stockholm, Sweden), suited for high accuracy dose calculations in a 1.5 T magnetic field, was coupled to our in-house developed Erasmus-iCycle optimizer. Clinically deliverable plans for 23 rectal cancer patients were automatically generated in a two-step process, i.e., multi-criterial fluence map optimization with Erasmus-iCycle followed by a conversion into a deliverable IMRT plan in the clinical TPS. Automatically generated plans (AUTOplans) were compared to plans that were manually generated with the clinical TPS (MANplans). Results: With AUTOplanning large reductions in planning time and workload were obtained; 4–6 h mainly hands-on planning for MANplans vs ∼1 h of mainly computer computation time for AUTOplans. For equal target coverage, the bladder and bowel bag Dmean was reduced in the AUTOplans by 1.3 Gy (6.9%) on average with a maximum reduction of 4.5 Gy (23.8%). Dosimetric measurements at the MRL demonstrated clinically acceptable delivery accuracy for the AUTOplans. Conclusions: A system for fully automated multi-criterial planning for a 1.5 T MR-Linac was developed and tested for rectal cancer patients. Automated planning resulted in major reductions in planning workload and time, while plan quality improved. Negative impact of the high magnetic field on the dose distributions could be avoided.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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