目的:评估八种主要商业治疗计划系统(TPSs)和剂量报告系统(DRS)的剂量体积直方图(DVH)结构差异,用于各种解剖部位和目标尺寸的临床治疗计划。
方法:来自10个选择的临床治疗计划的剂量文件,立体定向放射治疗处方或尖锐的剂量梯度,如头颈部计划,从1分18Gy的处方剂量到35分70Gy,每个计算为0.25厘米和0.125厘米网格尺寸,在EclipseTPS中创建和匿名化,并出口到其他七个主要的TPS(Pinnacle,RayStation,元素)和DRS(MIM,莫比乌斯,ProKnow,和速度)系统进行比较。从每个评估系统中收集每个计划临床重要性的剂量-体积约束点(D0.03cc[Gy],volume,并且平均剂量用于没有指定约束的结构)。将每个报告的约束类型和结构体积标准化为来自Eclipse的值,用于成对比较。使用Wilcoxon秩和检验进行统计显著性,并根据计划调整评估多变量回归模型,网格大小,以及到目标中心的距离。
结果:对于相对于Eclipse的所有DVH点,所有系统报告的中值彼此相差1.0%,然而,他们都不同于Eclipse。考虑到平均值,Pinnacle,RayStation,和元素的平均值分别为1.038、1.046、1.024,而MIM,莫比乌斯,ProKnow,和Velocity分别相对于Eclipse报告了1.026、1.050、1.033和1.022。较小的剂量网格尺寸略微改善了系统之间的一致性,没有统计学意义。对于相对于Eclipse的结构卷,在所有系统中都可以看到更大的差异,中位数差异高达3.0%,平均值差异高达10.1%。
结论:在所有系统之间观察到很大的差异。Eclipse通常报道,在统计上显著的水平,低于所有其他评估系统的值。降低剂量网格分辨率导致的非显著变化表明该分辨率可能不如计算DVH曲线的其他方面重要。例如结构的3D建模。
OBJECTIVE: To evaluate dose volume histogram (DVH) construction differences across 8 major commercial treatment planning systems (TPS) and dose reporting systems for clinically treated plans of various anatomic sites and target sizes.
METHODS: Dose files from 10 selected clinically treated plans with a hypofractionation, stereotactic radiation therapy prescription or sharp dose gradients such as head and neck plans ranging from prescription doses of 18 Gy in 1 fraction to 70 Gy in 35 fractions, each calculated at 0.25 and 0.125 cm grid size, were created and anonymized in Eclipse TPS, and exported to 7 other major TPS (Pinnacle, RayStation, and Elements) and dose reporting systems (MIM, Mobius, ProKnow, and Velocity) systems for comparison. Dose-volume constraint points of clinical importance for each plan were collected from each evaluated system (D0.03 cc [Gy], volume, and the mean dose were used for structures without specified constraints). Each reported constraint type and structure volume was normalized to the value from Eclipse for a pairwise comparison. A Wilcoxon rank-sum test was used for statistical significance and a multivariable regression model was evaluated adjusting for plan, grid size, and distance to target center.
RESULTS: For all DVH points relative to Eclipse, all systems reported median values within 1.0% difference of each other; however, they were all different from Eclipse. Considering mean values, Pinnacle, RayStation, and Elements averaged at 1.038, 1.046, and 1.024, respectively, while MIM, Mobius, ProKnow, and Velocity reported 1.026, 1.050, 1.033, and 1.022, respectively relative to Eclipse. Smaller dose grid size improved agreement between the systems marginally without statistical significance. For structure volumes relative to Eclipse, larger differences are seen across all systems with a range in median values up to 3.0% difference and mean up to 10.1% difference.
CONCLUSIONS: Large variations were observed between all systems. Eclipse generally reported, at statistically significant levels, lower values than all other evaluated systems. The nonsignificant change resulting from lowering the dose grid resolution indicates that this resolution may be less important than other aspects of calculating DVH curves, such as the 3-dimensional modeling of the structure.