Development and clinical evaluation of an automatic verification system for Oncentra brachytherapy treatment planning

Purpose Current manual workflows for verification of high-dose-rate (HDR) intracavitary and hybrid interstitial brachytherapy are labor-intensive and susceptible to errors. This study developed a fully automated verification system to evaluate plan integrity, quality, and dosimetric accuracy, with the aim of improving patient safety and clinical workflow efficiency.Methods and materials Featuring an automated verification pipeline for treatment plan integrity and a quality evaluation module, the system assesses key metrics: patient data, treatment parameters, applicator information, the number of CT slices, and volumetric and dosimetric constraints for all volumes of interest (VOIs). Additionally, an independent dose calculation based on the American Association of Physicists in Medicine Task Group No. 43 (TG-43) formalism is incorporated.Results A total of 79 cases successfully passed the integrity check, and the remaining six triggered system-generated warnings. Quality assessment confirmed that the majority of plans met all clinical constraints, with only minor clinically acceptable deviations observed in isolated cases. A mean Gamma passing rate of 98.70% (3%/2 mm criterion) was obtained in independent plan dose verification, and a positive correlation with the target volume was observed.Conclusions The implemented automated verification system is proven to be reliable and practical for clinical use. It enhances the efficiency of intracavitary and hybrid interstitial HDR brachytherapy plan quality assurance while effectively mitigating the risks associated with human error.