Abstract：
Previous plan competitions have largely focused on dose metric assessments. However, whether the submitted plans were realistic and reasonable from a quality assurance (QA) perspective remains unclear. This study aimed to investigate the relationship between aperture-based plan complexity metrics (PCM) in volumetric modulated arc therapy (VMAT) competition plans and clinical treatment plans verified through patient-specific QA (PSQA). In addition, the association of PCMs with plan quality was examined. A head and neck (HN) plan competition was held for Japanese institutions from June 2019 to July 2019, in which 210 competition plans were submitted. Dose distribution quality was quantified based on dose-volume histogram (DVH) metrics by calculating the dose distribution plan score (DDPS). Differences in PCMs between the two VMAT treatment plan groups (HN plan competitions held in Japan and clinically accepted HN VMAT plans through PSQA) were investigated. The mean (± standard deviation) DDPS for the 98 HN competition plans was 158.5 ± 20.6 (maximum DDPS: 200). DDPS showed a weak correlation with PCMs with a maximum r of 0.45 for monitor unit (MU); its correlation with some PCMs was \"very weak.\" Significant differences were found in some PCMs between plans with the highest 20% DDPSs and the remaining plans. The clinical VMAT and competition plans revealed similar distributions for some PCMs. Deviations in PCMs for the two groups were comparable, indicating considerable variability among planners regarding planning skills. The plan complexity for HN VMAT competition plans increased for high-quality plans, as shown by the dose distribution. Direct comparison of PCMs between competition plans and clinically accepted plans showed that the submitted HN VMAT competition plans were realistic and reasonable from the QA perspective. This evaluation may provide a set of criteria for evaluating plan quality in plan competitions.
摘要：
以前的计划竞赛主要集中在剂量度量评估上。然而,从质量保证（QA）的角度来看，提交的计划是否现实合理尚不清楚。本研究旨在调查体积调制电弧治疗（VMAT）竞争计划中基于孔径的计划复杂性度量（PCM）与通过患者特定QA（PSQA）验证的临床治疗计划之间的关系。此外,检查了PCMs与计划质量的相关性.2019年6月至2019年7月为日本机构举行了头颈（HN）计划竞赛，其中提交了210项竞赛计划。通过计算剂量分布计划评分(DDPS),基于剂量-体积直方图(DVH)度量量化剂量分布质量。调查了两个VMAT治疗计划组（在日本举行的HN计划竞赛和通过PSQA临床接受的HNVMAT计划）之间的PCM差异。98个HN竞争计划的平均(±标准偏差)DDPS为158.5±20.6(最大DDPS:200)。DDPS与PCM的相关性较弱，监测单位（MU）的最大r为0.45；它与某些PCM的相关性非常弱。“在某些PCM中，DDPS最高的20%的计划与其余计划之间存在显着差异。临床VMAT和竞赛计划显示某些PCM的分布相似。两组PCM的偏差具有可比性。表明规划者在规划技能方面存在相当大的差异。对于高质量计划，HNVMAT竞争计划的计划复杂性增加，如剂量分布所示。竞赛计划与临床接受计划之间的PCM的直接比较表明，从QA的角度来看，提交的HNVMAT竞赛计划是现实合理的。该评估可以提供用于在计划竞赛中评估计划质量的一组标准。
