title: Development of an autonomous treatment planning strategy for radiation therapy with effective use of population-based prior data.
abstract: OBJECTIVE
  Current treatment planning remains a costly and labor intensive procedure and requires multiple trial-and-error adjustments of system parameters such as the weighting factors and prescriptions. The purpose of this work is to develop an autonomous treatment planning strategy with effective use of prior knowledge and in a clinically realistic treatment planning platform to facilitate radiation therapy workflow.
  
  
  METHODS
  Our technique consists of three major components: (i) a clinical treatment planning system (TPS); (ii) a formulation of decision-function constructed using an assemble of prior treatment plans; (iii) a plan evaluator or decision-function and an outer-loop optimization independent of the clinical TPS to assess the TPS-generated plan and to drive the search toward a solution optimizing the decision-function. Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines for querying and interacting with the TPS. These subroutines are called back in the outer-loop optimization program to navigate the plan selection process through the solution space iteratively. The utility of the approach is demonstrated by using clinical prostate and head-and-neck cases.
  
  
  RESULTS
  An autonomous treatment planning technique with effective use of an assemble of prior treatment plans is developed to automatically maneuver the clinical treatment planning process in the platform of a commercial TPS. The process mimics the decision-making process of a human planner and provides a clinically sensible treatment plan automatically, thus reducing/eliminating the tedious manual trial-and-errors of treatment planning. It is found that the prostate and head-and-neck treatment plans generated using the approach compare favorably with that used for the patients' actual treatments.
  
  
  CONCLUSIONS
  Clinical inverse treatment planning process can be automated effectively with the guidance of an assemble of prior treatment plans. The approach has the potential to significantly improve the radiation therapy workflow.
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA, 94305-5847, USA.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA, 94305-5847, USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Dong
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA, 94305-5847, USA.
authors.forename: Hongcheng
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA, 94305-5847, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Xing
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D058958:Organs at Risk; D010363:Pattern Recognition, Automated / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012984:Software
keywords: 
  IMRT
  ; 
  VMAT
  ; dose optimization; inverse planning; treatment planning