World Championships of Treatment Planning (Update

February 14, 20186 minute read

This is the second update about the 2018 ProKnow World Championships of Treatment Planning. In the first update, we provided details about the goals, logistics, registration, and schedule for the 2018 event. Please click here to see those details.

In this second update, we give details on the following:

  1. Study Leadership Team
  2. Plan and Anatomy Details (Prescription, CT images, Anatomical Structures)
  3. Plan Metrics
  4. Recognition and Prizes

Note: In a subsequent update, about one week before the competition, we will publish the complete details of the plan-scoring algorithm. We will also provide dates, times, and links to join either of two web-based Q&A sessions. These will be recorded live and posted thereafter.

1. Study Leadership Team

For this first-of-its-kind study, we bring together a special planning team rich in plan study leadership experience. Below is a brief introduction of each planning team member.

Team Member

Sharath Narayan, C.M.D., M.B.A.
Absolute Oncology, LLC
Sharath is an expert in treatment planning and provides remote planning services across many planning systems, including Eclipse, Pinnacle, Monaco, XiO, and Tomotherapy. For this study, Sharath provides vital tasks of dataset research, preliminary contouring, metric design, and testing.

Aaron Kusano, M.D., S.M.
Anchorage & Valley Radiation Therapy Center
Aaron has built a (much deserved) reputation as one of the favorite speakers at AMMD meetings and leader for various contouring workshops Aaron brings his energy, clinical knowledge, and contouring skills to this study.

Greg Robinson, M.S., C.M.D., RT(T)
Sun Nuclear Corporation
Many of you know Greg from his early days with Radiation Oncology Resources (ROR), the team that started the international plan quality initiative, which was dubbed “The Plan Challenge.” Greg is bringing that experience and his passion to this study to help design the metrics and scoring algorithm, and to help review the final results.

Ben Nelms, Ph.D.
ProKnow Systems and Canis Lupus
Ben is the co-founder of ProKnow. He is an expert in medical physics, radiation therapy QA, and data analysis. Some of Ben’s inventions include the products and patented methods used for all plan and contouring studies. Ben facilitates ProKnow’s public and private plan studies.

2. Plan and Anatomy Details

Plan Details

The plan dataset is a GYN case with two PTVs to be planned for treatment in 25 fractions using a simultaneous integrated boost (SIB) technique. The prescription doses are 45 and 50 Gy (1.8 and 2.0 Gy/fraction).

CT Images

There are 180 high-quality CT images provided in the dataset. The CT study was performed without a vaginal marker, so there is no need to patch in tissue density anywhere. The CT image slice spacing is a uniform 2.5 mm.


All structures are pre-defined and will be distributed as a DICOM RT Structure Set associated with the aforementioned CT image study. A list of the structures provided is shown in the table below.

Contoured Structures
BM-PTV45 (BM = ‘bone marrow’)
Bone Marrow
Bowel Space
Femoral Head-Lt
Femoral Head-Rt
Involved LN
Large Bowel
Pelvic LN CTV
Pelvic LN PTV
Small Bowel
Uterocervix Vag2
Uterocervix Vagi

3. Plan Metrics

The metrics to be extracted and scored for this plan study, along with their respective weights, are shown in the table below. Two of the structures are created by Boolean ‘minus’ operators: (1) PTV45 minus PTV50 and (2) BONE MARROW minus PTV45.

Note about per-metric objectives: Each metric’s objectives and complete point score functions are already drafted and currently are under review by the team. These objectives and scoring details, along with a description of how they were derived, will be released 5-7 days prior to the competition. As always, plan metric extraction and scoring will be automated as a built-in tool via ProKnow’s real-time, online scoring engine (powered by PlanIQ™).

Target and Other Coverage MetricsWeight
1Volume (%) of the PTV45-PTV50 covered by 45 (Gy)12
2Volume (%) of the PTV45-PTV50 covered by 42.75 (Gy)7
3Volume (%) of the CTV45 covered by 45 (Gy)7
4Volume (%) of the PTV45-PTV50 covered by 47.25 (Gy)7
5Volume (%) of the PTV50 covered by 50 (Gy)12
6Volume (%) of the PTV50 covered by 47.5 (Gy)7
7Volume (%) of the CTV50 covered by 50 (Gy)7
8Dose (Gy) covering 0.03 (cc) of the PTV507
9Conformation Number of the 45 Gy dose level for the PTV4512
10Structure(s) containing the global max dose point5
Organs-at-risk and other sparing metricsWeight
11High dose volume of regret (cc) [55 (Gy), PTV45]5
12Volume (%) of the BOWEL SPACE covered by 40 (Gy)12
13Volume (%) of the ANORECTUM covered by 45 (Gy)12
14Volume (%) of the ANORECTUM covered by 50 (Gy)12
15Volume (%) of the BONE MARROW-PTV45 covered by 20 (Gy)12
16Volume (%) of the BLADDER covered by 45 (Gy)5
17Volume (%) of the BLADDER covered by 50 (Gy)5
18Volume (%) of the FEMORAL HEAD-LT covered by 30 (Gy)2
19Volume (%) of the FEMORAL HEAD-RT covered by 30 (Gy)2
Plan Efficiency and Other Inspection MetricsWeight
20Cumulative meterset (monitor units) over all treatment beams
21Estimated ‘beam-on’ time, all beams (minutes)
22Max dose voxel dimension (mm)
23Structure(s) not fully covered by dose grid

4. Recognition and Prizes


Winners will be determined based primarily on plan score and following directions (specifically, in creating realistic, treatable plans). Rules for monitor unit limits, delivery time estimates, number of beams and their allowed geometries, etc., will be published along with the full scoring algorithm in the next update.

To qualify for the ‘overall’ category, you must submit objective evidence of true composite dose QA (measured vs. calculated, in 2D or 3D phantom on couch as a patient surrogate) within 16 hours.

Recognition and Awards

We will announce the top three overall approximately 24 hours from the completion of the study. There will be a news article and video posted on the ProKnow website, and it will be announced via social media and email blast. ProKnow will be custom manufacturing special awards for the top three and shipping them, so make sure your correct work address is set in your ProKnow profile!

We will also post category awards (e.g., top 10-20% per TPS model). These high performers will be awarded double points (i.e., twice the normal plan study point value) in the ProKnow Achievement System.

Vendor Prizes

We are collecting prize donations for the per-TPS categories. We have contacted all major TPS vendors. Note: So far, we have only heard back from one of them (Varian), so if you work for a vendor and you are reading this, please contact us and direct us to the right marketing person within your organization!