Knowledge-Based Automatic Planning Optimization for Whole Breast Irradiation

This work explored effective strategies to automatize radiotherapy planning for whole breast irradiation, mimicking the classical tangential fields (TF) technique. An original arc technique (named Virtual Tangential-fields Arc Therapy, ViTAT) was first optimized to mimic TF. Then, using the commercial software RapidPlan (Varian Medical System, Inc), dose distributions of past clinical plans were used to train Knowledge-Based models: after proper validation, models were translated into individually-optimized templates for automatic plan optimization: ViTAT clinically replaced manual TF, also replacing the manual choice of beam angles. This approach was extended to the TomoDirect approach, delivering TF-like treatments with the Tomotherapy machine: the clinical implementation is currently on going.