PMID- 32951337
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 21
IP  - 10
DP  - 2020 Oct
TI  - Validation of the clinical applicability of knowledge-based planning models in 
      single-isocenter volumetric-modulated arc therapy for multiple brain metastases.
PG  - 141-150
LID - 10.1002/acm2.13022 [doi]
AB  - PURPOSE: To validate the clinical applicability of knowledge-based (KB) planning 
      in single-isocenter volumetric-modulated arc therapy (VMAT) for multiple brain 
      metastases using the k-fold cross-validation (CV) method. METHODS: This study 
      comprised 60 consecutive patients with multiple brain metastases treated with 
      single-isocenter VMAT (28 Gy in five fractions). The patients were divided 
      randomly into five groups (Groups 1-5). The data of Groups 1-4 were used as the 
      training and validation dataset and those of Group 5 were used as the testing 
      dataset. Four KB models were created from three of the training and validation 
      datasets and then applied to the remaining Groups as the fourfold CV phase. As 
      the testing phase, the final KB model was applied to Group 5 and the dose 
      distributions were calculated with a single optimization process. The dose-volume 
      indices (DVIs), modified Ian Paddick Conformity Index (mIPCI), modulation 
      complexity scores for VMAT plans (MCSv), and the total number of monitor units 
      (MUs) of the final KB plan were compared to those of the clinical plan (CL) using 
      a paired Wilcoxon signed-rank test. RESULTS: In the fourfold CV phase, no 
      significant differences were observed in the DVIs among the four KB plans (KBPs). 
      In the testing phase, the final KB plan was statistically equivalent to the CL, 
      except for planning target volumes (PTVs) D(2%) and D(50%) . The differences 
      between the CL and KBP in terms of the PTV D(99.5%) , normal brain, and D(max) to 
      all organs at risk (OARs) were not significant. The KBP achieved a lower total 
      number of MUs and higher MCSv than the CL with no significant difference. 
      CONCLUSIONS: We demonstrated that a KB model in a single-isocenter VMAT for 
      multiple brain metastases was equivalent in dose distribution, MCSv, and total 
      number of MUs to a CL with a single optimization.
CI  - (c) 2020 The Authors. Journal of Applied Clinical Medical Physics published by 
      Wiley Periodicals LLC on behalf of American Association of Physicists in 
      Medicine.
FAU - Kishi, Noriko
AU  - Kishi N
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Nakamura, Mitsuhiro
AU  - Nakamura M
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
AD  - Department of Information Technology and Medical Engineering, Division of Medical 
      Physics, Graduate School of Medicine, Human Health Sciences, Kyoto University, 
      Kyoto, Japan.
FAU - Hirashima, Hideaki
AU  - Hirashima H
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Mukumoto, Nobutaka
AU  - Mukumoto N
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Takehana, Keiichi
AU  - Takehana K
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Uto, Megumi
AU  - Uto M
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Matsuo, Yukinori
AU  - Matsuo Y
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Mizowaki, Takashi
AU  - Mizowaki T
AD  - Department of Radiation Oncology and Image-Applied Therapy, Graduate School of 
      Medicine, Kyoto University, Kyoto, Japan.
LA  - eng
GR  - 18H02766/JSPS KAKENHI/
GR  - 18K07700/JSPS KAKENHI/
GR  - 19K21271/JSPS KAKENHI/
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20200919
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
SB  - IM
MH  - *Brain Neoplasms/radiotherapy/surgery
MH  - Humans
MH  - *Radiosurgery
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated
PMC - PMC7592973
OTO - NOTNLM
OT  - k-fold cross-validation
OT  - knowledge-based planning
OT  - multiple brain metastases
OT  - single-isocenter VMAT
EDAT- 2020/09/21 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/09/19
CRDT- 2020/09/20 20:42
PHST- 2019/11/27 00:00 [received]
PHST- 2020/06/01 00:00 [revised]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/09/21 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/09/20 20:42 [entrez]
PHST- 2020/09/19 00:00 [pmc-release]
AID - ACM213022 [pii]
AID - 10.1002/acm2.13022 [doi]
PST - ppublish
SO  - J Appl Clin Med Phys. 2020 Oct;21(10):141-150. doi: 10.1002/acm2.13022. Epub 2020 
      Sep 19.