Assessing the accuracy of treatment planning system based radiotherapy structure volumes

Aim: The purpose of the present study was to assess the accuracy of radiotherapy (RT) structure volume generated by the Monaco treatment planning system (TPS) for three different computed tomography (CT) slice thicknesses. Further, this study addressed the important issue of 'different volumes of the same RT structure shown at different places' in the Monaco TPS. Also, the practical impact of this difference in structure volumes has been studied for brain or head and neck patients. Materials and Methods: Objects of known volumes were scanned with different CT slice thicknesses and contoured as an RT structure in Monaco TPS and two different volumes provided by the TPS for each RT structure were noted and compared with the real volumes of these objects. In addition, correlation was also assessed between TPS provided volumes and real volumes of these objects. The study was further extended to obtain correlation of volumes in cases of organs that exist in pairs (e.g., eye) in the human body. Results: Monaco TPS overestimates structure volumes except for objects with sharp corners. Although, volumes shown at different places of the same structure have nearly a linear correlation, volumes under structure table are more accurate than those shown under dose-volume histogram (DVH) statistics (total volume) table. Difference in magnitude between these two volumes has no correlation if this difference is analysed for paired organs. Findings: This study confirmed that Monaco TPS provides 'different value at different places' of the volume of a given contoured structure. It is recommended that this issue should be reviewed and resolved by the supplier.

Automated summary

The present study assessed the accuracy of radiotherapy structure volume generated by the Monaco treatment planning system for different CT slice thicknesses. It found that Monaco TPS tends to overestimate structure volumes and displays different volumes at different locations. This has practical implications for brain or head and neck patients. The supplier is recommended to address this issue.