Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis
(2020) In Physics and imaging in radiation oncology 14. p.82-86- Abstract
Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients... (More)
Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. Results: The plans in the central region of the Pareto front (1–4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5–4% PTV under-dosage) while medical physicists preferred better PTV coverage (1–2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5–1% PTV under-dosage). Conclusion: We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them.
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- author
- Kyroudi, A. ; Petersson, K. LU ; Ozsahin, E. ; Bourhis, J. ; Bochud, F. and Moeckli, R.
- publishing date
- 2020-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- CGA, Clinical decision making, Pareto fronts, Prostate, Trade-offs
- in
- Physics and imaging in radiation oncology
- volume
- 14
- pages
- 82 - 86
- publisher
- Elsevier
- external identifiers
-
- pmid:33458319
- scopus:85086454665
- ISSN
- 2405-6316
- DOI
- 10.1016/j.phro.2020.05.008
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2020 The Authors
- id
- acc67871-c749-46cb-ab4d-00e9578ab533
- date added to LUP
- 2021-11-03 18:18:53
- date last changed
- 2025-01-13 17:29:24
@article{acc67871-c749-46cb-ab4d-00e9578ab533,
abstract = {{<p>Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. Results: The plans in the central region of the Pareto front (1–4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5–4% PTV under-dosage) while medical physicists preferred better PTV coverage (1–2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5–1% PTV under-dosage). Conclusion: We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them.</p>}},
author = {{Kyroudi, A. and Petersson, K. and Ozsahin, E. and Bourhis, J. and Bochud, F. and Moeckli, R.}},
issn = {{2405-6316}},
keywords = {{CGA; Clinical decision making; Pareto fronts; Prostate; Trade-offs}},
language = {{eng}},
pages = {{82--86}},
publisher = {{Elsevier}},
series = {{Physics and imaging in radiation oncology}},
title = {{Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis}},
url = {{http://dx.doi.org/10.1016/j.phro.2020.05.008}},
doi = {{10.1016/j.phro.2020.05.008}},
volume = {{14}},
year = {{2020}},
}