Discrepancies in Dose-volume Histograms Generated from Different Treatment Planning Systems

  • Kim, Jung-in (Department of Radiation Oncology, Seoul National University Hospital) ;
  • Han, Ji Hye (Department of Physics, Ewha Womans University) ;
  • Choi, Chang Heon (Department of Radiation Oncology, Seoul National University Hospital) ;
  • An, Hyun Joon (Department of Radiation Oncology, Seoul National University Hospital) ;
  • Wu, Hong-Gyun (Department of Radiation Oncology, Seoul National University Hospital) ;
  • Park, Jong Min (Department of Radiation Oncology, Seoul National University Hospital)
  • Received : 2018.04.02
  • Accepted : 2018.05.25
  • Published : 2018.06.30


Background: We analyzed changes in the doses, structure volumes, and dose-volume histograms (DVHs) when data were transferred from one commercial treatment planning system (TPS) to another commercial TPS. Materials and Methods: A total of 22 volumetric modulated arc therapy (VMAT) plans for nasopharyngeal cancer were generated with the Eclipse system using 6-MV photon beams. The computed tomography (CT) images, dose distributions, and structure information, including the planning target volume (PTV) and organs at risk (OARs), were transferred from the Eclipse to the MRIdian system in digital imaging and communications in medicine (DICOM) format. Thereafter, DVHs of the OARs and PTVs were generated in the MRIdian system. The structure volumes, dose distributions, and DVHs were compared between the MRIdian and Eclipse systems. Results and Discussion: The dose differences between the two systems were negligible (average matching ratio for every voxel with a 0.1% dose difference criterion = $100.0{\pm}0.0%$). However, the structure volumes significantly differed between the MRIdian and Eclipse systems (volume differences of $743.21{\pm}461.91%$ for the optic chiasm and $8.98{\pm}1.98%$ for the PTV). Compared to the Eclipse system, the MRIdian system generally overestimated the structure volumes (all, p < 0.001). The DVHs that were plotted using the relative structure volumes exhibited small differences between the MRIdian and Eclipse systems. In contrast, the DVHs that were plotted using the absolute structure volumes showed large differences between the two TPSs. Conclusion: DVH interpretation between two TPSs should be performed using DVHs plotted with the absolute dose and absolute volume, rather than the relative values.


Supported by : National Research Foundation of Korea


  1. Gintz D, Latifi K, Caudell J, Nelms B, Zhang G, Moros E, Feygelman V. Initial evaluation of automated treatment planning software. J. Appl. Clin. Med. Phys. 2016;17(3):331-346.
  2. Ostheimer C, Hubsch P, Janich M, Gerlach R, Vordermark D. Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in total scalp irradiation: a single institutional experience. Radiat. Oncol. J. 2016;34(4):313-321.
  3. Alfonso JC, Herrero MA, Nunez L. A dose-volume histogram based decision-support system for dosimetric comparison of radiotherapy treatment plans. Radiat. Oncol. 2015;10:263.
  4. Drzymala RE, Mohan R, Brewster L, Chu J, Goitein M, Harms W, Urie M. Dose-volume histograms. Int. J. Radiat. Oncol. Biol. Phys. 1991;21(1):71-78.
  5. Ebert MA, Haworth A, Kearvell R, Hooton B, Hug B, Spry NA, Bydder SA, Joseph DJ. Comparison of DVH data from multiple radiotherapy treatment planning systems. Phys. Med. Biol. 2010;55(11):N337-346.
  6. Ackerly T, Andrews J, Ball D, Guerrieri M, Healy B, Williams I. Discrepancies in volume calculations between different radiotherapy treatment planning systems. Australas. Phys. Eng. Sci. Med. 2003;26(2):91-93.
  7. Dempsey JF, et al. A device for realtime 3D image-guided IMRT. Int. J. Radiat. Oncol. Biol. Phys. 2005;63(2):S202.
  8. Bostel T, Nicolay NH, Grossmann JG, Mohr A, Delorme S, Echner G, Haring P, Debus J, Sterzing F. MR-guidance - a clinical study to evaluate a shuttle- based MR-linac connection to provide MR-guided radiotherapy. Radiat. Oncol. 2014;9:12-19.
  9. Yang D, Wooten HO, Green O, Li HH, Liu S, Li x, Rodriguez V, Mutic S, Kashani R. A software tool to automatically assure and report daily treatment deliveries by a cobalt-60 radiation therapy device. J. Appl. Clin. Med. Phys. 2016;17(3):492-501.
  10. Mutic S, Dempsey JF. The ViewRay system: magnetic resonance-guided and controlled radiotherapy. Semin. Radiat. Oncol. 2014;24(3):196-199.
  11. Muralidhar KR, Pangam S, Srinivas P, Ali MA, Priya VS, Komanduri K. A phantom study on the behavior of Acuros XB algorithm in flattening filter free photon beams. J. Med. Phys. 2015;40(3):144-149.
  12. Olch AJ. Evaluation of the accuracy of 3DVH software estimates of dose to virtual ion chamber and film in composite IMRT QA. Med. Phys. 2012;39(1):81-86.
  13. Lee TY, Lin CH. Feature-guided shape-based image interpolation. IEEE Trans. Med. Imaging. 2002;21(12):1479-1489.
  14. Chuang KS, Chen CY, Yuan LJ, Yeh CK. Shape-based grey-level image interpolation. Phys. Med. Biol. 1999;44(6):1565-1577.
  15. Emami B, Lyman J, Brown A, Cola L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M. Tolerance of normal tissue to therapeutic irradiation. Int. J. Radiat. Oncol. Biol. Phys. 1991;21(1):109-122.
  16. Marks LB, Yorke ED, Jackson A, Ten Haken RK, Constine LS, Eisbruch A, Bentzen SM, Nam J, Deasy JO. Use of normal tissue complication probability models in the clinic. Int. J. Radiat. Oncol. Biol. Phys. 2010;76(3):S10-S19.
  17. Huang Z, Mayr NA, Yuh WT, Wang JZ, Lo SS. Reirradiation with stereotactic body radiotherapy: Analysis of human spinal cord tolerance using the generalized linear-quadratic model. Future Oncol. 2013;9(6):879-887.
  18. Sahgal A, et al. Reirradiation human spinal cord tolerance for stereotactic body radiotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2012;82(1):107-116.
  19. Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Seminars in Radiation Oncology. 2008;18(4):215-222.