Radiation therapy planning using a volumetric 3-D display: PerspectaRAD

We describe PerspectaRAD, the first tool for the review and modification of external-beam radiation therapy treatment plans with a volumetric three-dimensional display (Perspecta 1.9, Actuality Medical, Bedford, MA, USA) and a dedicated software application (PerspectaRAD, Actuality Medical). We summarize multi-institution retrospective studies that compare the system’s efficacy to the incumbent 2-D display-based workflow. Contributions include: visualizing the treatment plan in a volumetric 3-D display, modifying the beam locations and performing point-and-click measurement in 3-D with a 3-D physical interface, and simultaneously viewing volumetric projections of the native CT data and isodose contours. The plans are synchronized with the hospital treatment planning system, Pinnacle 3 (Philips Medical, WI, USA). In the largest of five studies, 33 plans were retrospectively randomized and replanned at three institutions, including 12 brain, 10 lung, and 11 abdomen / pelvis. The PerspectaRAD plan was as good as or better than plans created without PerspectaRAD 70% of the time. Radiation overdose regions were more likely to be obvious inside the target volume than when reviewed in the 2-D display alone. However, the planning time was longer with PerspectaRAD. The data demonstrate that PerspectaRAD facilitates the use of non-coplanar beams and has significant potential to achieve better plan quality in radiation therapy.