Investigating the Differences Between PlanIQ and IPA Planning Tools for Plan Optimization in Head & Neck Cancers
C Kabat1*, S Stathakis1, H Parenica1, N Papanikolaou1, S Das2, B Chera2, P Mavroidis2, (1) UT Health San Antonio MD Anderson Cancer Center, San Antonio, Texas, (2) University of North Carolina, Chapel Hill, NC
Presentations
PO-GePV-T-244 (Sunday, 7/25/2021) [Eastern Time (GMT-4)]
Purpose: To investigate treatment plan guidance for head and neck cancers via the feasibility tool PlanIQ (Sun Nuclear) and an open-source Ideal Planning Assistant (IPA) application.
Methods: Three patients with oropharyngeal squamous cell carcinoma were used to generate two sets of DVH guidance values for simultaneous integrated boost (SIB) treatment plans. In each case, 60Gy and 54Gy were prescribed to the high and standard risk PTVs. The PlanIQ feasibility tool generated values for the feasibility of 0.0, 0.1, and 0.5 for each OAR. To obtain similar feasibility values in the IPA application each OAR structure was pushed to the 90% value, providing a comparable 0.1 feasibility. Both tools assumed a 100% coverage of the PTVs with the prescription doses.
Results: At the regions of maximum doses and dose cutoffs (OAR - target overlap regions) both tools showed good agreement in predicting high difficulty of feasibility. However, lower doses for PlanIQ demonstrated the potential for greater sparing. For example, for the left and right parotids, planIQ indicates an average D50% 10.2Gy vs. 23.1Gy of IPA and 10.2Gy vs. 21.1Gy, respectively. Also, for the constrictors, PlanIQ indicates an average mean dose 26.3Gy vs. 45.2Gy of IPA. Those deviations mainly stem from the fact that PlanIQ accounts only for the target volume and OAR correlation, while PlanIQ considers the target volume in addition to dose sparing on all other defined OARs.
Conclusion: The comparison of PlanIQ and IPA showed good agreement in the high doses but significant differences in the middle and lower dose region. The results reflect their fundamental approaches since planIQ calculates its feasibility doses without considering any tradeoffs between the OARs, whereas IPA accounts for OAR to OAR dose tradeoffs to achieve a balanced sparing between organs.
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