Instruct: Identify the main and secondary category of Arxiv papers based on the titles and abstracts
Query: An institutional study on plan quality and variation of manual forward
  planning for Gamma Knife radiosurgery for vestibular schwannoma   Due to the complexity and cumbersomeness of Gamma Knife (GK) manual forward
planning, the quality of the resulting treatment plans heavily depends on the
planners skill, experience and the amount of effort devoted to plan
development. Hence, GK plan quality may vary significantly among institutions
and planners, and even for a same planner at different cases. This is
particularly a concern for challenging cases with complicated geometry, such as
vestibular schwannoma cases. The purpose of this retrospective study is to
investigate the plan quality and variation in the manually forward planned,
clinically acceptable GK treatment plans of 22 previous vestibular schwannoma
cases. Considering the impacts of different patient geometry and different
trade-offs among the planning objectives in GK planning, it is difficult to
objectively assess the plan quality across different cases. To reduce these
confounding factors on plan quality assessment, we employed our recently
developed multiresolution-level inverse planning algorithm to generate a golden
plan for each case, which is expected to be on or close to the pareto surface
with a similar trade-off as used in the manual plan. The plan quality of the
manual plan is then quantified in terms of its deviation from the golden plan.
A scoring criterion between 0-100 was designed to calculate a final score for
each manual plan to simplify our analysis. Large quality variation was observed
in these 22 cases, with two cases having a score lower than 75, three cases
scoring between 80 and 85, two cases between 85 and 90, eight cases between 90
and 95, and seven cases higher than 95. Inter- and intra- planner variability
was also observed in our study. This large variation in GK manual planning
deserves high attention, and merits further investigation on how to reduce the
variation in GK treatment plan quality.

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The categories of this paper are: astro-ph
4
The categories of this paper are: cond-mat
1
The categories of this paper are: cs
10
The categories of this paper are: q-bio
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The categories of this paper are: chao-dyn
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The categories of this paper are: eess
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The categories of this paper are: econ
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The categories of this paper are: alg-geom
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The categories of this paper are: math
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The categories of this paper are: funct-an
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The categories of this paper are: quant-ph
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The categories of this paper are: stat
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The categories of this paper are: math-ph
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The categories of this paper are: nucl-ex
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The categories of this paper are: cmp-lg
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The categories of this paper are: q-alg