Session Item

Purpose and objectives: Explore the benefits of using an in-house built treatment plan assessment framework (PlanQA) aimed at 1) quality improvement of training initiatives: to enhance treatment planning skills of radiotherapy technicians (RTTs) and to reduce variation in treatment planning outcome, by elucidating the implicit knowledge and by improving in-depth understanding, and 2) to objectively quantify the effects of various training initiatives.

Materials/methods: PlanQA is part of a framework configured to retrieve dicom objects, e.g. CTs, plans, doses, and contours, from the different environments of the treatment planning system (TPS), e.g. clinical and educational. This tool can be used to compare the planning output for treatment sites separately and to establish a comparison with the available norm, the actual constraints of the protocol. PlanQA was used in education initiatives for RTTs in training. The RTTs in training were given a planning exercise, where, after a few attempts, each developed a treatment plan for the same clinical lung cancer case. In a follow-up, there was a peer assessment meeting to discuss the similarities and differences between plans and incite discussions on the proposed techniques and underlying individual considerations during the process of planning. The tool was additionally used to judge the quality of current clinical techniques using a build-in OAR dose prediction function.

Results: The DVH metric values achieved by each RTT in training varied within the clinical constraints and a critical portrait of the learning development of every single student was feasible (Figure 1). Moreover, fruitful discussions on the decisions taken by the students as well as an overview of treatment quality in an educational sphere were possible, and consequently, learning materials were updated.

Conclusion: An independent tool for qualitative and quantitative plan quality assessment has been implemented for educational purposes. It provides an overview of treatment quality for RTTs in training learning how to plan and promotes in-depth discussions on different approaches to the same problem. Moreover, it allows to critically assess current treatment techniques and investigate fluctuations over time or between RTTs in treatment quality with respect to e.g. protocol changes, longitudinal drifts in quality, or benchmarking of new techniques.