PDF(Pubmed)
Abstract：
OBJECTIVE: Knowledge-based planning (KBP) aims to automate and standardize treatment planning. New KBP users are faced with many questions: How much does model size matter, and are multiple models needed to accommodate specific physician preferences? In this study, six head-and-neck KBP models were trained to address these questions.
METHODS: The six models differed in training size and plan composition: The KBPFull (n = 203 plans), KBP101 (n = 101), KBP50 (n = 50), and KBP25 (n = 25) were trained with plans from two head-and-neck physicians. KBPA and KBPB each contained n = 101 plans from only one physician, respectively. An independent set of 39 patients treated to 6000-7000 cGy by a third physician was re-planned with all KBP models for validation. Standard head-and-neck dosimetric parameters were used to compare resulting plans. KBPFull plans were compared to the clinical plans to evaluate overall model quality. Additionally, clinical and KBPFull plans were presented to another physician for blind review. Dosimetric comparison of KBPFull against KBP101 , KBP50 , and KBP25 investigated the effect of model size. Finally, KBPA versus KBPB tested whether training KBP models on plans from one physician only influences the resulting output. Dosimetric differences were tested for significance using a paired t-test (p < 0.05).
RESULTS: Compared to manual plans, KBPFull significantly increased PTV Low D95% and left parotid mean dose but decreased dose cochlea, constrictors, and larynx. The physician preferred the KBPFull plan over the manual plan in 20/39 cases. Dosimetric differences between KBPFull , KBP101 , KBP50 , and KBP25 plans did not exceed 187 cGy on aggregate, except for the cochlea. Further, average differences between KBPA and KBPB were below 110 cGy.
CONCLUSIONS: Overall, all models were shown to produce high-quality plans. Differences between model outputs were small compared to the prescription. This indicates only small improvements when increasing model size and minimal influence of the physician when choosing treatment plans for training head-and-neck KBP models.
METHODS: The six models differed in training size and plan composition: The KBPFull (n = 203 plans), KBP101 (n = 101), KBP50 (n = 50), and KBP25 (n = 25) were trained with plans from two head-and-neck physicians. KBPA and KBPB each contained n = 101 plans from only one physician, respectively. An independent set of 39 patients treated to 6000-7000 cGy by a third physician was re-planned with all KBP models for validation. Standard head-and-neck dosimetric parameters were used to compare resulting plans. KBPFull plans were compared to the clinical plans to evaluate overall model quality. Additionally, clinical and KBPFull plans were presented to another physician for blind review. Dosimetric comparison of KBPFull against KBP101 , KBP50 , and KBP25 investigated the effect of model size. Finally, KBPA versus KBPB tested whether training KBP models on plans from one physician only influences the resulting output. Dosimetric differences were tested for significance using a paired t-test (p < 0.05).
RESULTS: Compared to manual plans, KBPFull significantly increased PTV Low D95% and left parotid mean dose but decreased dose cochlea, constrictors, and larynx. The physician preferred the KBPFull plan over the manual plan in 20/39 cases. Dosimetric differences between KBPFull , KBP101 , KBP50 , and KBP25 plans did not exceed 187 cGy on aggregate, except for the cochlea. Further, average differences between KBPA and KBPB were below 110 cGy.
CONCLUSIONS: Overall, all models were shown to produce high-quality plans. Differences between model outputs were small compared to the prescription. This indicates only small improvements when increasing model size and minimal influence of the physician when choosing treatment plans for training head-and-neck KBP models.
摘要：
目的：基于知识的计划（KBP）旨在实现治疗计划的自动化和标准化。新的KBP用户面临许多问题：模型尺寸有多重要，以及需要多种模型来适应特定的医生偏好吗？在这项研究中，我们训练了6个头颈部KBP模型来解决这些问题.
方法：六个模型在训练规模和计划组成上有所不同：KBPFull（n=203计划），KBP101（n=101），KBP50(n=50),和KBP25（n=25）接受了两名头颈医生的计划培训。KBPA和KBPB分别包含仅来自一名医生的n=101计划，分别。用所有KBP模型重新计划由第三位医生治疗至6000-7000cGy的一组独立的39名患者用于验证。使用标准头颈部剂量测定参数来比较所得计划。将KBPFull计划与临床计划进行比较，以评估整体模型质量。此外,我们将临床和KBPFull计划提交给另一名医生进行盲检.KBPFull与KBP101的剂量学比较,KBP50,KBP25研究了模型尺寸的影响。最后,KBPA与KBPB测试了根据一位医生的计划训练KBP模型是否仅影响所得输出。使用配对t检验(p<0.05)测试剂量学差异的显著性。
结果：与手动计划相比，KBPFull显著增加PTV低D95%和左腮腺平均剂量，但减少耳蜗剂量，收缩器，还有喉部.在20/39例中，医生更喜欢KBPFull计划而不是手动计划。KBPFull之间的剂量差异，KBP101,KBP50,KBP25计划总计不超过187cGy，除了耳蜗.Further,KBPA和KBPB之间的平均差异低于110cGy。
结论：总体而言，所有模型都显示出高质量的计划。与处方相比，模型输出之间的差异很小。这表明在增加模型尺寸时只有很小的改进，并且在选择用于训练头颈部KBP模型的治疗计划时医生的影响最小。
方法：六个模型在训练规模和计划组成上有所不同：KBPFull（n=203计划），KBP101（n=101），KBP50(n=50),和KBP25（n=25）接受了两名头颈医生的计划培训。KBPA和KBPB分别包含仅来自一名医生的n=101计划，分别。用所有KBP模型重新计划由第三位医生治疗至6000-7000cGy的一组独立的39名患者用于验证。使用标准头颈部剂量测定参数来比较所得计划。将KBPFull计划与临床计划进行比较，以评估整体模型质量。此外,我们将临床和KBPFull计划提交给另一名医生进行盲检.KBPFull与KBP101的剂量学比较,KBP50,KBP25研究了模型尺寸的影响。最后,KBPA与KBPB测试了根据一位医生的计划训练KBP模型是否仅影响所得输出。使用配对t检验(p<0.05)测试剂量学差异的显著性。
结果：与手动计划相比，KBPFull显著增加PTV低D95%和左腮腺平均剂量，但减少耳蜗剂量，收缩器，还有喉部.在20/39例中，医生更喜欢KBPFull计划而不是手动计划。KBPFull之间的剂量差异，KBP101,KBP50,KBP25计划总计不超过187cGy，除了耳蜗.Further,KBPA和KBPB之间的平均差异低于110cGy。
结论：总体而言，所有模型都显示出高质量的计划。与处方相比，模型输出之间的差异很小。这表明在增加模型尺寸时只有很小的改进，并且在选择用于训练头颈部KBP模型的治疗计划时医生的影响最小。
