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Dumane et al. J Cancer Metastasis Treat 2019;5:42 Journal of Cancer
DOI: 10.20517/2394-4722.2019.08 Metastasis and Treatment

Original Article Open Access

Training and evaluation of a knowledge-based
model for automated treatment planning of multiple

brain metastases

Vishruta A. Dumane, Tsu-Chi Tseng, Ren-Dih Sheu, Yeh-Chi Lo, Vishal Gupta, Audrey Saitta, Kenneth E.
Rosenzweig, Sheryl Green

Departmentof Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

Correspondence to: Dr. Vishruta A. Dumane, Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, 1184
5th Avenue, Box 1236, New York, NY 10029, USA. E-mail: vishruta.dumane@mountsinai.org

How to cite this article: Dumane VA, Tseng TC, Sheu RD, Lo YC, Gupta V, Saitta A, Rosenzweig KE, Green S. Training and
evaluation of a knowledge-based model for automated treatment planning of multiple brain metastases. J Cancer Metastasis
Treat 2019;5:42. http://dx.doi.org/10.20517/2394-4722.2019.08

Received: 14 Jan 2019 First Decision: 12 Feb 2019 Revised: 25 Mar 2019 Accepted: 15 Apr 2019 Published: 14 May 2019

Science Editor: Lucyna Kepka Copy Editor: Cai-Hong Wang Production Editor: Huan-liang Wu

Abstract
Aim: Volumetric modulated arc therapy (VMAT) has been utilized to plan and treat multiple cranial metastases
using a single isocenter due to its ability to provide steep dose gradients around targets as well as low doses to
critical structures. VMAT treatment is delivered in a much shorter time compared to using a single isocenter for the
treatment of each lesion. However, there is a need to develop methods to reduce the treatment planning time for
these cases while also standardizing the plan quality. In this work we demonstrate the use of RapidPlan, which is
knowledge-based treatment (KBP) planning software to plan multiple cranial SRS cases.

Methods: The 66 patient plans with 125 lesions (range 1-4, median 1) were used to train a model. In addition, the
model was validated using 10 cases that were previously treated and chosen randomly. The clinical plans were
compared to plans generated by RapidPlan for target coverage and critical organ dose.

Results: Coverage to the target volume, gradient index, conformity index and minimum dose to the target showed no
significant difference between the original clinical plan vs. the plan generated by KBP. A comparison of doses to the
critical organs namely the brainstem, brain, chiasm, eyes, optic nerves and lenses showed no significant difference.
Target dose homogeneity was slightly better with the clinical plan, however this difference was also statistically
insignificant.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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