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Standardization of knowledge-based volumetric modulated arc therapy planning with a multi-institution model (broad model) to improve prostate cancer treatment quality

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Abstract

Purpose: To evaluate whether knowledge-based volumetric modulated arc therapy plans for prostate cancer with a multi-institution model (broad model) are clinically useful and effective as a standardization method. Methods: A knowledge-based planning (KBP) model was trained with 561 prostate VMAT plans from five institutions with different contouring and planning policies. Five clinical plans at each institution were reoptimized with the broad and single institution model, and the dosimetric parameters and relationship between Dmean and the overlapping volume (rectum or bladder and target) were compared. Results: The differences between the broad and single institution models in the dosimetric parameters for V50, V80, V90, and Dmean were: rectum; 9.5% ± 10.3%, 3.3% ± 1.5%, 1.7% ± 1.6%, and 3.6% ± 3.6%, (p < 0.001), bladder; 8.7% ± 12.8%, 1.5% ± 2.6%, 0.7% ± 2.4%, and 2.7% ± 4.6% (p < 0.02), respectively. The differences between the broad model and clinical plans were: rectum; 2.4% ± 4.6%, 1.7% ± 1.7%, 0.7% ± 2.4%, and 1.5% ± 2.0%, (p = 0.004, 0.015, 0.112, and 0.009) bladder; 2.9% ± 5.8%, 1.6% ± 1.9%, 0.9% ± 1.7%, and 1.1% ± 4.8%, (p < 0.018), respectively. Positive values indicate that the broad model has a lower value. Strong correlations were observed (p < 0.001) in the relationship between Dmean and the rectal and bladder volume overlapping with the target in the broad model (R = 0.815 and 0.891, respectively). The broad model had the smallest R2 of the three plans. Conclusions: KBP with the broad model is clinically effective and applicable as a standardization method at multiple institutions.

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Data Availability

The dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Dr Mikoto Tamura, Mr. Takahiro Hara, and Mr. Masashi Kimura (Varian Medical Systems) for their valuable support. We thank Ashleigh Cooper, PhD, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This work was supported partly by Japan Society for the Promotion of Science (JSPS) KAKENHI grant number 20K08093.

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Authors and Affiliations

  1. Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8567, Japan

    Yoshihiro Ueda

  2. Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi- ku, Fukuoka, 812-8582, Japan

    Jun-ichi Fukunaga

  3. Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Tatsuya Kamima

  4. Department of Radiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka Ward, Hamamatsu, Shizuoka, 430-8558, Japan

    Yumiko Shimizu

  5. Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan

    Kazuki Kubo & Hajime Monzen

  6. Department of Radiation Oncology, Faculty of Medicine, Kindai University, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan

    Hiroshi Doi

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  1. Yoshihiro Ueda
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Contributions

Concept and design: Y.U., J.F., T.K., Y.S., K.K., H.M. Acquisition of data: Y.U., J.F., T.K., Y.S., K.K., H.D., H.M. Data analysis: Y.U., J.F., T.K., Y.S., K.K., H.M. Drafting the article: Y.U., J.F., T.K., Y.S., K.K., H.M. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yoshihiro Ueda.

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Competing interests

The authors declare that they have no competing interests.

Ethics approval

This study was approved at all Institutional Ethical Review Committees. (Kindai University Review Board No. 31–273, Kyushu University Review Board No. 2020– 286, JFCR Review Board No. 2020–1049, Seirei Hamamatsu General Hospital Review Board No. 3333, Osaka International Cancer Institute Review Board No. 20050).

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The institutional consent form was obtained from the patients.

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The authors affirm that human research participants provided informed consent for publication of the images in Fig. 1.

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Ueda, Y., Fukunaga, Ji., Kamima, T. et al. Standardization of knowledge-based volumetric modulated arc therapy planning with a multi-institution model (broad model) to improve prostate cancer treatment quality. Phys Eng Sci Med 46, 1091–1100 (2023). https://doi.org/10.1007/s13246-023-01278-9

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