title: Application of holographic display in radiotherapy treatment planning II: a multi-institutional study.
abstract: We hypothesized that use of a true 3D display providing easy visualization of patient anatomy and dose distribution would lead to the production of better quality radiation therapy treatment plans. We report on a randomized prospective multi-institutional study to evaluate a novel 3D display for treatment planning.The Perspecta Spatial 3D System produces 360 degrees holograms by projecting crosssectional images on a diffuser screen rotating at 900 rpm. Specially-developed software allows bi-directional transfer of image and dose data between Perspecta and the Pinnacle planning system.Thirty-three patients previously treated at three institutions were included in this IRB-approved study. Patient data were de-identified, randomized, and assigned to different planners. A physician at each institution reviewed the cases and established planning objectives. Two treatment plans were then produced for each patient, one based on the Pinnacle system alone and another in conjunction with Perspecta. Plan quality was then evaluated by the same physicians who established the planning objectives. All plans were viewable on both Perspecta and Pinnacle for review. Reviewing physicians were blinded to the planning device used. Data from a 13-patient pilot study were also included in the analysis.Perspecta plans were considered better in 28 patients (61%), Pinnacle in 14 patients (30%), and both were equivalent in 4 patients. The use of non-coplanar beams was more common with Perspecta plans (82% vs. 27%). The mean target dose differed by less than 2% between rival plans. Perspecta plans were somewhat more likely to have the hot spot located inside the target (43% vs. 33%). Conversely, 30% of the Pinnacle plans had the hot spot outside the target compared with 18% for Perspecta plans. About 57% of normal organs received less dose from Perspecta plans. No statistically significant association was found between plan preference and planning institution or planner.The study found that use of the holographic display leads to radiotherapy plans preferred in a majority of cases over those developed with 2D displays. These data indicate that continued development of this technology for clinical implementation is warranted.
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: James C H
authors.initials: JCH
authors.lastname: Chu
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Xing
authors.initials: X
authors.lastname: Gong
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kirk
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Zusag
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
authors.affiliation: Tufts-New-England Medical Center, Boston, MA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Rivard
authors.affiliation: Tufts-New-England Medical Center, Boston, MA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Melhus
authors.affiliation: Rhode Island Hospital Brown Medial School, Providence, RI.
authors.forename: Gene A
authors.initials: GA
authors.lastname: Cardarelli
authors.affiliation: Rhode Island Hospital Brown Medial School, Providence, RI.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hurley
authors.affiliation: Tufts-New-England Medical Center, Boston, MA.|Rhode Island Hospital Brown Medial School, Providence, RI.
authors.forename: Jaroslaw T
authors.initials: JT
authors.lastname: Hepel
authors.affiliation: Actuality Medical, Inc., Bedford, MA.
authors.forename: Josh
authors.initials: J
authors.lastname: Napoli
authors.affiliation: Actuality Medical, Inc., Bedford, MA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Stutsman
authors.affiliation: Rush University Medical Center, Chicago, IL.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Abrams
mesh_terms: D006696:Holography / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods*
references.citation: Radiother Oncol. 2007 Feb;82(2):218-21
references.pmid: 17224194
references.citation: J Appl Clin Med Phys. 2009 Jul 17;10(3):96-114
references.pmid: 19692974