title: Cross-institutional knowledge-based planning (KBP) implementation and its performance comparison to Auto-Planning Engine (APE).
abstract: To investigate (1) whether a plan library established at one institution can be applied for another institution's knowledge-based planning (KBP); (2) the performance of cross-institutional KBP compared to Auto-Planning Engine (APE).
  
  
  
  Radboud University Medical Center (RUMC) provided 35 oropharyngeal cancer patients (68Gy to PTV68and 50.3Gy to PTV50.3) with clinically-delivered and comparative APE plans. The Johns Hopkins University (JHU) contributed a three-dose-level plan library consisting of 179 clinically-delivered plans. MedStar Georgetown University Hospital (MGUH) contributed a KBP approach employing overlap-volume histogram (OVH-KBP), where the JHU library was used for guiding RUMC patients' KBP. Since clinical protocols adopted at RUMC and JHU are different and both approaches require protocol-specific planning parameters as initial input, 10 randomly selected patients from RUMC were set aside for deriving them. The finalized parameters were applied to the remaining 25 patients for OVH-KBP and APE plan generation. A Wilcoxon rank-sum test was used for statistical comparison.
  
  
  
  PTV68and PTV50.3's V95in OVH-KBP and APE were similar (p>0.36). Cord's D0.1 ccin OVH-KBP was reduced by 5.1Gy (p=0.0001); doses to other organs were similar (p>0.2).
  
  
  
  APE and OVH-KBP's plan quality is comparable. Institutional-protocol differences can be addressed to allow cross-institutional library sharing.
authors.affiliation: Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, USA. Electronic address: wub@mskcc.org.
authors.forename: Binbin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Kusters
authors.affiliation: Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Martina
authors.initials: M
authors.lastname: Kunze-Busch
authors.affiliation: Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Dijkema
authors.affiliation: Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University, Baltimore, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: McNutt
authors.affiliation: Department of Radiotherapy, Istituto Nazionale Tumori Regina Elena, Roma, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sanguineti
authors.affiliation: Philips Radiation Oncology Systems, Madison, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Bzdusek
authors.affiliation: Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, USA.
authors.forename: Anatoly
authors.initials: A
authors.lastname: Dritschilo
authors.affiliation: Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, USA.
authors.forename: Dalong
authors.initials: D
authors.lastname: Pang
mesh_terms: D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016896:Treatment Outcome
keywords: APE; IMRT; KBP; OVH