PMID- 36067722 OWN - NLM STAT- MEDLINE DCOM- 20221004 LR - 20221004 IS - 1872-9800 (Electronic) IS - 0969-8043 (Linking) VI - 189 DP - 2022 Nov TI - Development and evaluation of a three-step automatic planning technique for lung SBRT based on performance examination of advanced settings in Pinnacle's auto-planning module. PG - 110434 LID - S0969-8043(22)00319-0 [pii] LID - 10.1016/j.apradiso.2022.110434 [doi] AB - The benefits of Pinnacle's auto-planning module on clinical practice have been well documented. However, little is known regarding the efficiency of its Advanced Settings and the practicality of incorporating this module into Stereotactic Body Radiation Therapy (SBRT), which is why this research was conducted. To characterize the impact of Advanced Settings on plan quality, a total of 25 previously delivered postoperative cervical cases were re-planned and evaluated. Then a three-step automatic planning technique was developed and tested on ten lung SBRT cases based on the investigation. The differences between plans with fine-tuned Advanced Settings and the default were compared using a Wilcoxon signed-rank test with a significance threshold of 5%. The same statistical analysis was implemented to examine the quality variations in manual and automatic SBRT planning. When the Tuning Balance, Dose Fall-Off Margin, and Hot-Spot Maximum Goal were set to 100%, 1 cm, and 250%, respectively, better organ-at-risk (OAR) sparing was reached, but target quality was compromised. The OAR dose reduction and target homogeneity deterioration showed a strong correlation. The three-step methodology improved high dose spillage while saving time, with statistically significant reductions of 66.7% in V105% of non-PTV and 58.1% in planning time to the human-driven strategy. Except for urgent requirements for sparing OARs or processing SBRT plans, keeping the default is appropriate for Advanced Settings. The three-step methodology automatically searches for the available solution with purposeful Advanced Settings adjustments, demonstrating its ability to produce high-quality plans in less time. For the inexperienced or under-resourced clinics, our procedure can be introduced as a robust and handy strategy in SBRT, notably for expedited quality planning. CI - Copyright (c) 2022 Elsevier Ltd. All rights reserved. FAU - An, Xiao-Gang AU - An XG AD - Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, China. Electronic address: aner0414@163.com. FAU - Dong, Zhi-Wei AU - Dong ZW AD - Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, China. LA - eng PT - Journal Article DEP - 20220829 PL - England TA - Appl Radiat Isot JT - Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine JID - 9306253 SB - IM MH - Humans MH - Lung MH - *Lung Neoplasms/diagnostic imaging/radiotherapy/surgery MH - Planning Techniques MH - *Radiosurgery/methods MH - Radiotherapy Dosage MH - Radiotherapy Planning, Computer-Assisted/methods MH - *Radiotherapy, Intensity-Modulated/methods OTO - NOTNLM OT - Advanced settings OT - Auto-planning OT - IMRT OT - Lung SBRT OT - Three-step methodology OT - Time advantage COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/09/07 06:00 MHDA- 2022/10/05 06:00 CRDT- 2022/09/06 18:27 PHST- 2022/04/23 00:00 [received] PHST- 2022/08/16 00:00 [revised] PHST- 2022/08/24 00:00 [accepted] PHST- 2022/09/07 06:00 [pubmed] PHST- 2022/10/05 06:00 [medline] PHST- 2022/09/06 18:27 [entrez] AID - S0969-8043(22)00319-0 [pii] AID - 10.1016/j.apradiso.2022.110434 [doi] PST - ppublish SO - Appl Radiat Isot. 2022 Nov;189:110434. doi: 10.1016/j.apradiso.2022.110434. Epub 2022 Aug 29.