Development and Implementation of Automated Clinical Treatment Planning (ACT) for Routine Prostate and Breast Treatments

Objective To create and implement Automated Clinical Treatment Planning (ACT) for routine prostate and breast treatments at local institution. Methods A prior dosimetry and timing audit of breast and prostate manual treatment planning was performed. Key manual planning steps for automation were identified in Eclipse TPS, which was used to create the ACT framework. ACT was written in C# using Varian Eclipse API scripting. Dosimetry and timing efficiency from ACT planning were compared to manual planning during initial testing phase and as part of the clinical rollout. Results ACT was tested on a set of 20 breast/prostate patients during initial testing. ACT was able to generate clinically acceptable treatment plans for all the evaluated breast and prostate patients. The time saving given by ACT significantly reduced total treatment planning time for breast and prostate to approximately 15-30 minutes including checking patient documentations and care path, with actual ACT plan creation time of ∼2-4 minutes, compared to approximately 1 hour for manual planning. Conclusion ACT was successfully developed, tested and clinically implemented for routine breast and prostate treatments at our local institution. ACT produced plans dosimetrically equivalent to manual planning, requiring little manual interaction for most cases, with significant timesaving. The described development and implementation framework will form the basis for further treatment site rollout. Advances in knowledge ACT produces tangential hybrid IMRT Breast and VMAT Prostate plans within minutes and is fully integrated within Eclipse TPS. ACT was successfully introduced into a large, busy clinical department, freeing radiotherapy planning staff to perform other, more complex planning tasks.