Getting Started with the Plan Study Program


This article introduces the Plan Study Program, a tool that allows you to measure quality, study variation, and share best practices with a global community. Read on to learn more.

What is it?

ProKnow Plan Studies are the tried-and-true method to establish benchmarks, study variability, and derive, then share, "best practices" in radiation treatment planning.

We use a well-designed process that incorporates objective and real-time plan scoring. We also provide tools for interactive population analysis so you can compare your results against your peers and study the capabilities of different planning systems and modalities. What you learn helps you optimize your performance and make data-driven decisions to benefit your staff, your institution, and your patients.

How does it work?

The process is easy. The results are powerful.

An organizing committee comes up with the case study dataset (images and anatomy) and sets up the comprehensive plan scoring rules. ProKnow’s cloud-based system allows participants to download the controlled data then iteratively create and score the plan (and dose) they create with their treatment planning system (TPS). All results are shown to the user in real-time.

When the data collection phase is complete, the results are published to the particular plan study community (public, or private organization) as an interactive module allowing you to study population statistics, benchmark quality, do TPS-by-TPS and modality-by-modality breakdowns, and analyze efficiency (e.g., estimated delivery time). For public plan studies, high performers provide recorded and/or written interviews to explain their methods and help others achieve the same level of excellence.

How are plan scores calculated, you might ask? Well, one of our core missions is to cooperate with leading vendors in the field of radiation therapy. As such, we’ve partnered with Sun Nuclear Corporation, the worldwide leader in dosimetry and QA solutions, to integrate their well-established and proven PlanIQ™ scoring formalism. This method will be used in all public plan studies and by request for organization-based plan studies.

Who should participate in each plan study?

Everyone is encouraged to participate in every study!

Whether you have 25 years of experience or are still a student, the Plan Study Program is for you. Whether your clinic treats the particular body site or method or not, you should participate. Whether you have the latest, greatest TPS software or whether you have an older, lower performing system, you should participate.

Your participation adds knowledge for our community. As always, all results are fully secure and anonymous, with the exception of “high-performers” who opt to be recognized by name and volunteer to be interviewed about their planning methods. See our article about privacy for more information.

Do you audit submitted plans to ensure that nobody "cheats" to get a high score?

ProKnow expects all users to honestly create realistic and deliverable plans, using accurate beam models and dose calculation algorithms, when participating in plan studies.

Though improbable, it is possible for users to "cheat" by altering a beam model (e.g. create impossible gradients are zero transmission through MLC leaves) or by hacking electron density values to result in very low dose in some regions.

Here are some of the ways that ProKnow guards against such illicit behavior:

  • "High performers" in public plan studies are asked to deliver a fraction of their plan to a QA phantom and submit their QA results. This is great information to have and helps ensure that plans are practical and can be delivered accurately and in a reasonable fraction time.
  • Top plans are independently audited by inspecting the submitted DICOM data, including the volumetric dose.
  • In all cases, DVH data are calculated independently by ProKnow. This also removes variables due to known TPS deficiencies in terms of DVH calculations.
  • If we find any users who have attempted to submit dishonest plans, their results are discounted, they are contacted directly, and all future submissions will come under higher scrutiny.

When will the interactive analytics and population stats be posted?

Study results for “public” plan studies, including statistical analysis of all metrics and plan composite scores, will be posted for all participants as soon as the study is closed and the results presentation has been given or publication has been submitted.

You will be notified when population results are posted for you to study. Once posted, each participant will be able to return to their ProKnow portal at any time to interactively study their individual results vs. the population.

How are plan scores calculated?

Each ProKnow plan study is configured with a unique scoring algorithm. For more details, please see our Plan Study Scoring article.

What's next?

  1. Sign in to your ProKnow account. If you don't have one, sign up for free.
  2. Access a ProKnow plan study in the Plan Studies module.
  3. Learn how to participate in a plan study. Visit our Participating in a Plan Study article.
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