KEY POINTS
- Investigators developed an automated lattice radiotherapy evaluation tool using the Eclipse Scripting Application Programming Interface version 16.1. The system calculates peak-to-valley dose ratios, equivalent uniform dose, ablative dose ratio, conventional dose-volume metrics, and organ-at-risk parameters.
- The software used four functional layers covering user interaction, computation, direct read-only treatment-planning-system access, and report generation. A separate preprocessing script divided aggregated lattice structures into individual spherical vertices because Eclipse security restrictions prevented structure creation during the main evaluation.
- Clinical validation included 12 lung cancer lattice plans with internal target volumes ranging from 137.34 to 354.25 cm³. Plans contained two to eight vertices with median centre-to-centre spacing of approximately 26–30 mm, and prescribed 12 or 15 Gy in one fraction to the lattice vertices.
- Standard dose-volume parameters showed perfect agreement with manual treatment-planning-system queries. For spatially explicit valley-to-peak analysis, the mean absolute error between automated and manually measured values was 0.034, while equivalent uniform dose estimates differed by less than 3% from published reference values.
- Comprehensive evaluation time fell from 15.41 ± 3.20 minutes manually to 1.97 ± 0.34 minutes automatically, representing a 7.8-fold efficiency gain. The automated workflow also removed operator dependence in profile placement and valley-dose sampling.
- The five implemented peak-to-valley methods produced substantially different absolute values. Mean results ranged from 3.11–4.77 for the compressed spatial or mean-dose approaches to 22.70 and 35.46 for the D10/D90 and Wu methods, demonstrating that these definitions are not interchangeable across studies.
- Sphere preprocessing preserved geometry closely: the median summed-volume difference was 0.0%, and 9 of 12 cases differed by less than 2%. Even where relative underestimation reached 5.3%, the absolute discrepancy remained below 0.1 cm³.
- Validation was limited to one institution, one Eclipse version, lung plans, and comparison with measurements from a single physicist. The system evaluates static dose on the average-intensity CT and does not account for respiratory motion or dose smearing.
CLINICAL TAKEAWAY
The tool could make post-planning assessment of lattice radiotherapy faster and more reproducible while exposing how strongly reported heterogeneity metrics depend on the chosen definition. It provides useful technical infrastructure for research and multicentre standardization, but requires broader validation before routine deployment or use in plan-acceptance decisions.