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Improving Pancreas SBRT Treatment Planning with PlanIQ

G Kuzmin1*, M Abazeed1 , M Kolar1 , A Magnelli1 , P Xia1 , S Balik1 , (1) Cleveland Clinic, Cleveland, OH


(Monday, 7/15/2019) 3:45 PM - 4:15 PM

Room: Exhibit Hall | Forum 7

Purpose: To use predicted organ doses from a commercial product (PlanIQ) to further reduce dose to OARs for pancreas SBRT treatment plans.

Methods: A commercial product, PlanIQ, which utilizes target and organ at risk (OAR) geometry to indicate the difficulty of achieving different planning goals for organ dose-volume histograms (DVH) was used as the planning objective for 10 clinically approved pancreas SBRT plans. The re-planning emphasized maximally sparing the stomach, bowel, and duodenum while maintaining tumor dose coverage. The PlanIQ-driven re-plans used the same beam arrangement and energy as the clinically approved plans while blinded to the dosimetric results of the plans. Planning began by using the max and mean values from the FDVH analysis as inputs to the Pinnacle AutoPlanâ„¢ algorithm followed by further manual optimization. Optimizations were stopped when the optimizer could no longer reduce the dose to the OARs without compromising the 95% coverage of both the low dose and high dose PTVs.

Results: The PlanIQ-driven plans were able to achieve better OAR sparing while maintaining the same tumor dose coverage. For bowel, duodenum, and stomach, the max dose was reduced by 9.8% (p < 0.001) and the mean dose was reduced by 3.8 % (p < 0.05).

Conclusion: PlanIQ-driven plans were able to reduce OAR dose compared to the clinically delivered plans. The use of PlanIQ FDVH analysis to guide pancreas SBRT planning may improve sparing of nearby OARs. Currently, more plans and other plan quality metrics are being investigated to further improve pancreas SBRT treatment planning.


Treatment Planning, Stereotactic Radiosurgery


TH- External beam- photons: treatment planning/virtual clinical studies

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