Rx: 30Gy/10fx


2:19 VMAT treatment arc delivery time

Simple DVH Metrics

Name (ID): AAMD2015, HCSWB_SIB (AAMD2015)
Plan or PlanSum ID: HCSWBnorm95

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
PTV_WB_noSIB   PTV_WB_noSIB V30.0Gy[%] >=95 90   Goal 95.11 %
PTV_WB_noSIB   PTV_WB_noSIB D98.0%[Gy] >=26 25   Goal 26.325 Gy
PTV_WB_noSIB   PTV_WB_noSIB D2.0%[Gy] <=37.5 40   Goal 35.127 Gy
HIPPOCAMPUS_TOTL   Hippocampus_Totl D0.03cc[Gy] <=16 17   Goal 14.334 Gy
HIPPOCAMPUS_TOTL   Hippocampus_Totl Min[Gy] <=9 11   Goal 7.258 Gy
CHIASM   Chiasm D0.03cc[Gy] >=37.5 30   Variation 30.671 Gy
LOPTIC   Loptic D0.03cc[Gy] <=30 37.5   Variation 30.942 Gy
ROPTIC   Roptic D0.03cc[Gy] <=30 37.5   Variation 30.780 Gy
LLENS   LLens D0.03cc[Gy] <=6 10   Goal 5.858 Gy
RLENS   RLens D0.03cc[Gy] <=6 10   Goal 5.667 Gy
LEYE   Leye Mean[Gy] <=8 15   Goal 7.876 Gy
REYE   Reye Mean[Gy] <=8 15   Goal 7.924 Gy
BRAINSTEM   Brainstem D0.03cc[Gy] <=34.5 37.5   Goal 34.305 Gy
LLACRIMAL   LLacrimal Mean[Gy] <=10 20   Goal 8.616 Gy
RLACRIMAL   RLacrimal Mean[Gy] <=10 20   Goal 9.013 Gy
CORD   Cord D0.03cc[Gy] <=30 37.5   Goal 26.186 Gy
Technical Plan Comments

Four (4) arc VMAT technique was chosen and 4 almost complete arcs were used.  Each arc used a different start and stop angle (offset by 1 degree) to stagger the available control points throughout each arc rotation and unique collimator rotations per field were automatically generated utilizing the arc geometry tool.  The inverse planning optimizer was populated utilizing the free hippocampal sparring RapidPlan HSWBv1 model below.

This 2016 version of the Rapidplan model is only still recommened for Eclipse V13.X users.  Newer version users should see the HSWBv2 model below and sample it's performance at the VMAT2 toggle above.

No changes were made to the objectives, only the model documentation suggested pausing and unpausing of the VMAT optimizer at each MR sub-step.  The RapidPlan model was designed for use with a non-coplanar 4 arc beam arrangement with 2 vertex arcs, but this beam arrangement proved not to be critical as the resulting coplanar plan created here is of high clinical quality (if perhaps a bit less homogeneous than a plan created with a non-coplanar beam arrangement). 

Even though the RapidPlan model was tuned to provide maximal hippocampal sparring, beyond what is requested by the NRG-CC001 protocol, this plan proved impressive in this regard reaching a minimum hippocampal dose almost 2Gy below what is requested by the protocol.  This machine’s ability to produce plans with such aggressively spared hippocampi structures could be attributable to the two-stage stacked and staggered MLC with very low interleaf leakage.

Physician Comments

Whole brain plan to 30 Gy. Hippocampal sparing is achieved with a 7-8 Gy dose to the hipoccampal areas. Nothing remarkable otherwise. Good homogeneity. This is a clinically acceptable plan.


Supporting Documents

Download RapidPlan Model

DICOM patient export

3rd party plan report




HSWBv1 AAMD2017 Poster



HSWBv1 Clinical Description



Any reference to a "plan study" are simply what the organizers call each case and may not be a "study" in the FDA sense as they may not have been published in a peer reviewed journal.
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