{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:42:12Z","timestamp":1792165332059,"version":"4.4.0"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,8,30]],"date-time":"2017-08-30T00:00:00Z","timestamp":1504051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2017,9]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Designing a radiation plan that optimally delivers both target coverage and normal tissue sparing is challenging. There are limited tools to determine what is dosimetrically achievable and frequently the experience of the planner\/physician is relied upon to make these determinations. PlanIQ<\/jats:styled-content> software provides a tool that uses target and organ at risk (OAR<\/jats:styled-content>) geometry to indicate the difficulty of achieving different points for organ dose\u2013volume histograms (DVH<\/jats:styled-content>). We hypothesized that PlanIQ<\/jats:styled-content> Feasibility DVH<\/jats:styled-content> may aid planners in reducing dose to OAR<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Methods and materials<\/jats:title>Clinically delivered head and neck treatments (clinical plan) were re\u2010planned (re\u2010plan) putting high emphasis on maximally sparing the contralateral parotid gland, contralateral submandibular gland, and larynx while maintaining routine clinical dosimetric objectives. The planner was blinded to the results of the clinically delivered plan as well as the Feasibility DVH<\/jats:styled-content>s from PlanIQ<\/jats:styled-content>. The re\u2010plan treatments were designed using 3\u2010arc VMAT<\/jats:styled-content> in Raystation (RaySearch Laboratories, Sweden). The planner was then given the results from the PlanIQ<\/jats:styled-content> Feasibility DVH<\/jats:styled-content> analysis and developed an additional plan incorporating this information using 4\u2010arc VMAT<\/jats:styled-content> (IQ<\/jats:styled-content> plan). The DVH<\/jats:styled-content>s across the three treatment plans were compared with what was deemed \u201cimpossible\u201d by PlanIQ<\/jats:styled-content>'s Feasibility DVH<\/jats:styled-content> (Impossible DVH<\/jats:styled-content>). The impossible DVH<\/jats:styled-content> (red) is defined as the DVH<\/jats:styled-content> generated using the minimal dose that any voxel outside the targets must receive given 100% target coverage.<\/jats:p><\/jats:sec>Results<\/jats:title>The re\u2010plans performed blinded to PlanIQ<\/jats:styled-content> Feasibilty DVH<\/jats:styled-content> achieved superior sparing of aforementioned OAR<\/jats:styled-content>s compared to the clinically delivered plans and resulted in discrepancies from the impossible DVH<\/jats:styled-content>s by an average of 200\u2013700 cG<\/jats:styled-content>y. Using the PlanIQ<\/jats:styled-content> Feasibility DVH<\/jats:styled-content> led to additional<\/jats:italic>OAR<\/jats:styled-content> sparing compared to both the re\u2010plans and clinical plans and reduced the discrepancies from the impossible DVH<\/jats:styled-content>s to an average of approximately 100 cG<\/jats:styled-content>y. The dose reduction from clinical to re\u2010plan and re\u2010plan to IQ<\/jats:styled-content> plan were significantly different even when taking into account multiple hypothesis testing for both the contralateral parotid and the larynx (P<\/jats:italic> < 0.004 for all comparisons). No significant differences were observed between the three plans for the contralateral parotid when considering multiple hypothesis testing.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Clinical treatment plans and blinded re\u2010plans were found to suboptimally spare OAR<\/jats:styled-content>s. PlanIQ<\/jats:styled-content> could aid planners in generating treatment plans that push the limits of OAR<\/jats:styled-content> sparing while maintaining routine clinical target coverage goals.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.12165","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T11:38:34Z","timestamp":1504179514000},"page":"245-250","source":"Crossref","is-referenced-by-count":35,"title":["Assessment of PlanIQ<\/scp> Feasibility DVH<\/scp> for head and neck treatment planning"],"prefix":"10.1002","volume":"18","author":[{"given":"David V.","family":"Fried","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhishamjit S.","family":"Chera","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva K.","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2011.11.012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70290-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.06.090"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-014-0255-x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.09.004"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.03.079"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.01.047"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.12.045"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.6199"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.11.014"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12500"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facm2.12165","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.12165","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.12165","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.12165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:16:49Z","timestamp":1694362609000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.12165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,30]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1002\/acm2.12165"],"URL":"https:\/\/doi.org\/10.1002\/acm2.12165","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,30]]}}}