Evaluation of plan quality improvements in PlanIQ-guided Autoplanning

Aim: Philips recently integrated PlanlQwith Autoplan (R) in Pinnacle(3) TPS (V16.2). The objective of the present work is to quantitatively demonstrate how this integration improves the plan quality. Background: Pinnacle(3) Autoplan (R) is the tool that generates the treatment plans with clinically acceptable plan quality with less manual intervention. In the recent past, a new tool called PlanIQ (Sun Nuclear Corp.) was introduced for a priori estimation of the best possible sparing of an organ at risk (OAR) for a given patient anatomy. Philips has recently integrated PlanIQ tool with Autoplan (R) for a seamless and efficient planning workflow. Materials and methods: We have performed this evaluation in Pinnacle(3) TPS (V.16.2) for the VMAT treatment technique. All plans were created using Varian True beam machine with the dual arc technique. Basically, we created two sets of VMAT plans using 6 MV photons. In the first set of VMAT plans (AP_RTOG), we used OAR goals from either RTOG guidelines to perform optimization using Autoplan (R). Subsequently, we exported the same dataset to the PlanIQ system to perform feasibility analysis on the OAR goals. These newly obtained OAR goals from PlanIQ were used to generate the other set of plans (AP_PlanIQ plans). We compared the dosimetric results from these two sets of plans in five cases, such as brain, head & neck, lung, abdomen and prostate. Results: We compared the dosimetric results for AP_RTOG and AP_PlanIQ plans. We used RTOG guidelines to evaluate the plans and observed that while both sets of plans were meeting the RTOG guidelines in terms of OAR sparing, the AP_PlanIQplans were significantly better in terms of OAR sparing as compared to AP_RTOG plans without any compromise in the target coverage. Conclusion: The results indicate that, although Autoplan helps achieve the user-defined goals without much manual intervention, the plan quality (OAR sparing) can be significantly improved without taking many iterative steps when PlanIQ suggested clinical goals are used in the Autoplan-based optimization. Advances in knowledge: At present, there are no published material available about the efficacy of the integration of PlanIQ with Autoplanning (R). In the present work, our objective is to evaluate the improvements in plan quality resulting from this integration. (C) 2019 Greater Poland Cancer Centre. Published by Elsevier B.V. All rights reserved.