radiation-planning-assistant-streamlined-fully-automated-radiotherapy

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated ...

radiation-planning-assistant-web-based-tool-to-support-high-quality

Radiation Planning Assistant - A Web-based Tool to Support High-quality Radiotherapy in Clinics with Limited Resources

Access to radiotherapy worldwide is limited. The Radiation Planning Assistant (RPA) is a fully automated, web-based tool that is being developed to offer ...

Groote Schuur Hospital and University of Cape Town

To fully evaluate the efficacy of intracranial stereotactic irradiation, tumour control needs to be assessed in conjunction with the effects of radiation on normal tissue and the potential for changes in physiology, cognition and quality of life. This prospective pilot study investigated whether intracranial stereotactic irradiation induces cognitive changes in patients with cranial and base of skull lesions that did not directly involve the brain parenchyma. The value of a software-based psychometric approach to neurocognitive testing was also examined.

Evaluation of the potential of inducing neurocognitive changes in patients receiving intracranial stereotactic irradiation for benign tumors: a preliminary study.

Effective treatment of children with low grade glioma (LGG) requires a functioning multi-disciplinary team with adequate neurosurgical, neuroradiological, pathological, radiotherapy and chemotherapy facilities and personnel. In addition, the treating centre should have the capacity to manage a variety of LGG and treatment-associated complications. These requirements have made it difficult for many centers in low and middle-income countries (LMIC) to offer effective treatment and follow up. This article provides management recommendations for children with LGG according to the level of facilities available.

SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings.

Purpose We assessed automated contouring of normal structures for patients with head-and-neck cancer (HNC) using a multiatlas deformable-image-registration algorithm to better provide a fully automated radiation treatment planning solution for low- and middle-income countries, provide quantitative analysis, and determine acceptability worldwide. Methods Autocontours of eight normal structures (brain, brainstem, cochleae, eyes, lungs, mandible, parotid glands, and spinal cord) from 128 patients with HNC were retrospectively scored by a dedicated HNC radiation oncologist. Contours from a 10-patient subset were evaluated by five additional radiation oncologists from international partner institutions, and interphysician variability was assessed. Quantitative agreement of autocontours with independently physician-drawn structures was assessed using the Dice similarity coefficient and mean surface and Hausdorff distances. Automated contouring was then implemented clinically and has been used for 166 patients, and contours were quantitatively compared with the physician-edited autocontours using the same metrics. Results Retrospectively, 87% of normal structure contours were rated as acceptable for use in dose-volume-histogram-based planning without edit. Upon clinical implementation, 50% of contours were not edited for use in treatment planning. The mean (± standard deviation) Dice similarity coefficient of autocontours compared with physician-edited autocontours for parotid glands (0.92 ± 0.10), brainstem (0.95 ± 0.09), and spinal cord (0.92 ± 0.12) indicate that only minor edits were performed. The average mean surface and Hausdorff distances for all structures were less than 0.15 mm and 1.8 mm, respectively. Conclusion Automated contouring of normal structures generates reliable contours that require only minimal editing, as judged by retrospective ratings from multiple international centers and clinical integration. Autocontours are acceptable for treatment planning with no or, at most, minor edits, suggesting that automated contouring is feasible for clinical use and in the ongoing development of automated radiation treatment planning algorithms.

Retrospective Validation and Clinical Implementation of Automated Contouring of Organs at Risk in the Head and Neck: A Step Toward Automated Radiation Treatment Planning for Low- and Middle-Income Countries.

To estimate the concrete density of a newly constructed bunker using impact-echo testing prior to the installation of the linear accelerator.

Concrete density estimation of linac bunker walls using impact-echo testing.

Radiation treatment planning for head and neck cancer is a complex process with much variability; automated treatment planning is a promising option to improve plan quality and efficiency. This study compared radiation plans generated from a fully automated radiation treatment planning system to plans generated manually that had been clinically approved and delivered.

Clinical Acceptability of Automated Radiation Treatment Planning for Head and Neck Cancer Using the Radiation Planning Assistant.

The role of radiotherapy (RT) in cancer care is well described, with a clear correlation between access to radiotherapy and overall survival. Cancer mortality rates in Africa are substantially higher than those of the rest of the world, which may be partly attributed to lack of RT access and insufficient human resources. The Access to Care (A2C) Cape Town RT training programme was created in 2014 with the aim of supplementing practical RT training in the region, focusing on clinics moving from 2 to 3D conformal radiotherapy (3DCRT). The programme makes use of hybrid teaching methods, including pre-course e-learning followed by 17 on-site days of free-thinking design exercises, didactic learning, hands-on treatment planning computer sessions (39% of total teaching time), virtual simulation training and departmental demonstration sessions. Email support is offered to all teams for 3 months after each course to develop clinical protocols. Thirteen teams (radiation oncologist, medical physicist and radiation therapy technologist) from Africa attended the course between 2015 and 2019, with additional participants from seven South African and four international centres. E-learning done on the LäraNära training platform was only successful once formal progress tracking was introduced in 2019 (34% vs. 76% test completion rate). Delays between course attendance and initial clinical use of equipment proved to be detrimental to knowledge retention, with some centres having to send a second team for training. The course will be modified for remote teaching in 2021, to make provision for the global changes in travel due to Covid-19.

Bridging the Radiotherapy Education Gap in Africa: Lessons Learnt from the Cape Town Access to Care Training Programme Over the Past 5 Years (2015-2019).

Pediatric patients with medulloblastoma in low- and middle-income countries (LMICs) are most treated with 3D-conformal photon craniospinal irradiation (CSI), a time-consuming, complex treatment to plan, especially in resource-constrained settings. Therefore, we developed and tested a 3D-conformal CSI autoplanning tool for varying patient lengths.

Automating the treatment planning process for 3D-conformal pediatric craniospinal irradiation therapy.

Target delineation for radiation therapy is a time-consuming and complex task. Autocontouring gross tumor volumes (GTVs) has been shown to increase efficiency. However, there is limited literature on post-operative target delineation, particularly for CT-based studies. To this end, we trained a CT-based autocontouring model to contour the post-operative GTV of pediatric patients with medulloblastoma.

ArticleTotal : 2	Year
Publication title Cited by 60	2018
Publication title Cited by 6	2023

Article	Year
Evaluation of the potential of inducing neurocognitive changes in patients receiving intracranial stereotactic irradiation for benign tumors: a preliminary study. Journal of radiosurgery and SBRT\| PubMed ID: 29296379	2014
SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings. Pediatric blood & cancer\| PubMed ID: 29297618	2017
Retrospective Validation and Clinical Implementation of Automated Contouring of Organs at Risk in the Head and Neck: A Step Toward Automated Radiation Treatment Planning for Low- and Middle-... Journal of global oncology\| PubMed ID: 30110221	2018
Concrete density estimation of linac bunker walls using impact-echo testing. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)\| PubMed ID: 32777700	2020
Clinical Acceptability of Automated Radiation Treatment Planning for Head and Neck Cancer Using the Radiation Planning Assistant. Practical radiation oncology\| PubMed ID: 33640315	2021
Bridging the Radiotherapy Education Gap in Africa: Lessons Learnt from the Cape Town Access to Care Training Programme Over the Past 5 Years (2015-2019). Journal of cancer education : the official journal of the American Association for Cancer Education\| PubMed ID: 33928527	2022
Automating the treatment planning process for 3D-conformal pediatric craniospinal irradiation therapy. Pediatric blood & cancer\| PubMed ID: 36591994	2023
Resection cavity auto-contouring for patients with pediatric medulloblastoma using only CT information. Journal of applied clinical medical physics\| PubMed ID: 36917640	2023

Hester Burger

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