title: Quantitative metrics for assessing plan quality.
abstract: Despite many studies over the last 3 decades that have attempted to explicitly quantify the decision-making process for radiotherapy treatment plan evaluation, judgments of an individual plan's degree of quality are still largely subjective and can show inter- and intra-practitioner variability even if the clinical treatment goals are the same. Several factors conspire to confound the full quantification of treatment plan quality, including uncertainties in dose response of cancerous and normal tissue, the rapid pace of new technology adoption, and the human component of treatment planning. However, new developments in clinical informatics and automation are lowering the bar for developing and implementing quantitative metrics into the treatment planning process. This review discusses general strategies for using quantitative metrics in the treatment planning process and presents a case study in intensity-modulated radiation therapy planning whereby control was established on a variable system via such techniques.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO 63110, USA. kmoore@radonc.wustl.edu
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Moore
authors.forename: R Scott
authors.initials: RS
authors.lastname: Brame
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Low
authors.forename: Sasa
authors.initials: S
authors.lastname: Mutic
mesh_terms: D003657:Decision Making; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010347:Patient Care Planning; D011787:Quality of Health Care; D018787:Radiation Oncology / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D015203:Reproducibility of Results; D013673:Technology Assessment, Biomedical; D013679:Technology, Radiologic