Background and purpose: Current automated planning methods do not allow for the intuitive exploration of clinical trade-offs during calibration. This work introduces a novel automated planning solution, which aimed to address this problem through incorporating Pareto navigation techniques into the calibration process. The efficacy of this new solution was evaluated for prostate cancer patients with and without elective nodal irradiation. Materials and methods: The developed automated planning methodology was as follows. For each tumour site a set of planning goals is defined. Utilising Pareto navigation techniques an operator calibrates the solution through intuitively exploring different treatment options: selecting the optimum balancing of competing planning goals for the given site. Once calibrated, fully automated plan generation is possible, with specific algorithms implemented to ensure trade-off balancing of new patients is consistent with that during calibration. Using the proposed methodology the system was calibrated for prostate and seminal vesicle (PSV), and prostate and pelvic node (PPN) treatments. For 40 randomly selected patients (20 PSV and 20 PPN) automatically generated plans (VMATAuto) were compared against plans created by expert dosimetrists under clinical conditions (VMATClinical) and no time pressures (VMATIdeal). Plans were compared through quantitative comparison of dosimetric parameters and blind review by an oncologist. Results: Upon blind review 39/40 and 33/40 VMATAuto plans were considered preferable or equal to VMATClinical and VMATIdeal respectively, with all deemed clinically acceptable. Dosimetrically, VMATAuto, VMATClinical and VMATIdeal were similar, with observed differences generally of low clinical significance. Compared to VMATClinical, VMATAuto reduced hands-on planning time by 94% and 79% for PSV and PPN respectively. Total planning time was significantly reduced from 22.2 mins to 14.0 mins for PSV, with no significant reduction observed for PPN. Conclusions: An automated planning methodology with a Pareto navigation based calibration has been developed, enabling the complex balancing of competing trade-offs to be intuitively incorporated into automated protocols. It was successfully applied to two sites of differing complexity and robustly generated high quality plans in an efficient manner.
Date of Award | 31 Dec 2022 |
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Original language | English |
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Awarding Institution | - The University of Manchester
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Supervisor | Ranald Mackay (Supervisor) |
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- Radiotherapy
- Prostate Cancer
- Automation
Development of Pareto Guided Automated Radiotherapy Treatment Planning and its Application to Prostate Cancer
Wheeler, P. (Author). 31 Dec 2022
Student thesis: Unknown