Follow-Up Replan Activity - Started  

This activity is intended for those who are interested to participate in the competition and challenge themselves to achieve high quality plans, whether they have already participated in the first competition (LT Breast case) or would like to join our community.

In this follow-up replan activity, the participants will plan this tough LT Breast case using the guidance of the best planners in their corresponding TPS. The materials shared will be considered as guidelines or directions for participants to achieve high quality plans.

Also the live-webinar video series on our YouTube channel can also be viewed by clicking at the following link
This is the registration link for the follow-up replan competition:

This is the link for our Radiotherapy Plan Competition YouTube channel to view the webinars per TPS:




Live-Webinar Presentation:
  • To download the “Results Announcement Live-Webinar Presentation” please Download
  • To download the “3D-CRT Live-Webinar Presentation” please Download
  • Eclipse TPS Webinar Presentations:

Ahmad Nobah – Introduction:  Download
Saad Aldelaijan – The Best RapidArc Plan:  Download
Vanessa & Anthony Magliary – The IMRT Plan:  Download

  • Monaco TPS Webinar Presentations:

Mamta Mahur – The Best VMAT Plan:  Download
Rui Silva – The VMAT Plan:  Download

  • Pinnacle TPS Webinar Presentations:

Timothee Ruef – The Best VMAT Plan:  Download
Ludovic Michon – The VMAT Plan:  Download

  • Dmytro S - Tomotherapy Webinar Presentation: Download
  • Hugues Mailluex (The highest score of our competition)- RayStation Webinar Presentation Download
  • Ahmad Nobah – Conclusion: Download

Live-Webinar List:

  • Eclipse Live-Webinar: June 2, 2016  (Done)
  • Monaco Live-Webinar: June 16, 2016 (Done)
  • Pinnacle Live-Webinar: June 22, 2016 (Done)
  • Tomotherapy Live-Webinar: July 14, 2016 (Done)
  • RayStation Live-Webinar: July 17, 2016 (Done)
  • Follow-Up plan: Aug 14, 2016

Competition YouTube Channel:

  • Visit our YouTube Channel to be able to watch all the live-webinar videos
  • Please Subscribe to our channel to receive all the updates and the new activities

Please join us in congratulating top planners for their remarkable performance.


Hugues Mailleux

Score: 98.2 / 100
Job Title: Medical Physicist
Hospital: Institut Paoli-Calmettes
Years of Experience: 20
Technique: VMAT
TPS: RayStation
Country: France

Fazal Khan

Score: 98.1 / 100
Job Title:Proton Dosimetrist
Hospital: Massachusetts General Hospital
Years of Experience: 7
Technique: VMAT
TPS: RayStation
Country: USA


Mikel Byrne

Score: 96.8 / 100
Job Title: Medical Physics Specialist
Hospital: ROC Wahroonga
Years of Experience: 7
Technique: VMAT
TPS: RayStation
Country: Australia

Cameron Ditty, MSc, DABR

Score: 96.7 / 100
Job Title: Senior Physicist Specialist
Hospital: RaySearch Americas
Years of Experience: 13
Technique: VMAT
TPS: RayStation
Country: USA


Khodri Mustapha

Score: 95.4 / 100
Job Title: Medical Physicist
Hospital: ORLAM
Years of Experience: 23
Technique: VMAT
TPS: Raystation
Country: France

Simon Heinze

Score: 94.6 / 100
Job Title: Medical Physicist SSRMP
Hospital: Kantonsspital Sr. Gallen
Years of Experience: 5
Technique: VMAT
TPS: Tomotherapy
Country: Switzerland


Timothee Ruef

Score: 94.0 / 100
Job Title: Medical Physicist
Hospital: Pôle d’imagerie et cancérologie du Pont St Vaast
Years of Experience: 3
Technique: VMAT
TPS: Pinnacle
Country: France

Ludovic Michon

Score: 93.9 / 100
Job Title: Medical Physicist
Hospital: CRT Versailles
Years of Experience: 6
Technique: VMAT
TPS: Pinnacle
Country: France


Saad Aldelaijan

Score: 93.6 / 100
Job Title: Medical Physicist
Hospital: King Faisal Specialist Hospital & Research Centre
Years of Experience: 3
Technique: VMAT
TPS: Eclipse
Country: Saudi Arabia

Perumal Murugan

Score: 92.0 / 100
Job Title: Medical Physicist
Hospital : Sri Shankara Cancer Hospital & Research Centre
Years of Experience: 8
Technique: IMRT
TPS: Eclipse
Country: India


Le Bourhis Julien

Score: 91.5 / 100
Job Title: Medical Physicist
Hospital: Centre Clinique de la Porte de Saint Cloud
Years of Experience: 4
Technique: VMAT
TPS: Pinnacle
Country: France
Working Place
Hugues Mailleux
Institut Paoli-Calmettes
Fazal Khan
Mass. Gen. Hospital
Mikel Byrne
Cameron Ditty
RaySearch - America
Mustapha Khodri
Simon Heinze
Kantonsspital Sr. Gallen
Timothee Ruef
Pôle d’imagerie et cancérologie du Pont St Vaast
Ludovic Michon
CRT Versailles
Saad Aldelaijan
KFSH&RC - Riyadh
Saudi Arabia
Perumal Murugan
Sri Shankara Cancer Hospital & Research Centre
Le Bourhis Julien
Centre Clinique de la Porte de Saint Cloud
Laurent Tantôt
Hôpital Maisonneuve-Rosemont
Craig Koontz
Comprehensive Cancer Centers of Nevada
Nguyen Daniel
Vanessa Magliari
Rolf Wiehle
Klinik für Strahlenheilkunde, Uniklinik Freiburg
Julien Rolland
Jansen Mendez
Makati Medical Center
Dmytro S Synchuk
Ukrainian Center of Tomotherapy
Brett Sloman
Auzac Guillame
Gustave Roussy
Helical IMRT
Rui Silva
Lenitudes Medical Center
Luke Mackowiak
Monongahela Valley Hospital
Vaclav Bednar
Svet zdravia, a.s.
  • About the
  • The Competition
  • The Evaluation
  • Statistics
    of 2016
  • Important
  • Evaluation
  • Evaluation
What is the plan competition?

It is a national competition, through which planners from the Kingdom of Saudi Arabia, the Middle East, and other areas of the world can challenge themselves and generate high quality radiotherapy plans.
What are the benefits?

Beyond personal knowledge and enhanced skills, the cancer patient will have the best quality plan. The competing environment will improve the level of planners and this will have a direct impact on their day-to-day clinical performance.

Will there be any prizes for the top scores?

It is a national/international competition

- A number of valuable prizes will be distributed for the top scores during a dedicated event.

- The top 20 scores will be posted permanently on the website.

Who can participate?

All treatment planners from Saudi Arabia, the Middle East, and other areas of the world.


Please Click here for 2016 Radiotherapy Plan Competition Poster




A valuable document that includes a summary of step-by-step procedure for generating high quality plan of the Left breast case will be prepared and distributed to participants. The guidelines will be gathered in a single document called: "Left Breast Planning Guidelines: 2016 Plan Competition Outcomes".

The step-by-step procedure will explain strategies of planning throughout the following stages:
1. Contouring
2. Fields' geometry and parameters
3. Optimization criteria
4. Dose calculation

Re-plan Evaluation:
1. For planners who are interested, they will re-plan the same case (LT Breast) using the suggested guidelines in the document provided.
2. Their new plans will be evaluated and compared with the original plans. This will provide them with a quantitative measure of the improvement of their planning skills.



The evaluation tool used in this competition, both for benchmarking and also scoring is the Plan IQ software from Sun Nuclear Corporation.

PlanIQ is a software to be used together with any Treatment Planning System (TPS), that checks the feasibility of the clinical goals before starting the planning process and quantifies the plan quality with a sophisticated and simple to use plan quality metric score. PlanIQ makes sense of your clinical goals on a patient-specific basis, and tells you not only if the goals are feasible, but how you can do better. PlanIQ scores your treatment plans based on clinical goals and feasibility, quantifying treatment plan quality

• Clinical goal feasibility. Before starting the planning process the software is able predict whether a specific clinical goal is achievable for a specific patient.

• A numerical quality score for every Target and OAR clinical goal and for the entire treatment plan.

• Standard and customized protocols including RTOG

• Statistical analysis of performance records

• Quick analysis of non-dosimetric plan parameters (grid resolution and size, non-coplanar beams, MU, limits) as part of a Physics plan check

• Automated and comprehensive treatment plan reports

For more information about the PlanIQ software, click here

      • The highest score was 98.2/100, top planners were from different continents
      • Around (21) planners scored above 80/100
Important Dates
Feb 4, 2016 Participants received data set and started planning
Feb 18, 2016 Participants will receive a link to upload their best plan
Feb 24, 2016 ICRM-2016: Plan Competition: An initiative towards better quality
March 25, 2016 A dedicated event: Results announcement and prizes
Apr 4, 2016 Results announcements: Live-webinar
Apr 21, 2016 Live-Webinar Session 1: 3D-CRT (Done)
May 12, 2016 Live-Webinar Session 2: RayStation TPS
(postponed until further notice)
June 2, 2016 Live-Webinar Session 3: Eclipse TPS
June 16, 2016

Live-Webinar Session 4: Monaco TPS
June 22, 2016 Live-Webinar Session 5: Pinnacle TPS
July 14, 2016 Live-Webinar Session 6: Tomotherapy TPS
July 17, 2016 Live-Webinar Session 7: RayStation TPS
July 22, 2016< Re-plan Evaluation: Re-plan using planning guidelines provided
August 14, 2016 Follow-up Plan
Thank you for being part of this competition
in its first edition...
We would really appreciate it if you can kindly fill the feedback form in order for us to improve our next competition and make sure that the content of this competition will be very handy and useful for planners worldwide.
Evaluation Form  
Evaluation Responses
165 Forms Submitted

Thank you for this competition. it was a really interesting challenge !! Which allows us to excel and have different approaches.
I'm really impressed how much positive energy did you delivered to my working atmosphere. I don't have chances to meet and communicate very often with professionals like you - ready to share knowledge and help others. You reminded me why I signed for this job, I was starting to forget somehow. Thank you for that, sincerely.
Congratulations for the idea and thank you for the experience.
Thank you for organizing such even, it helps us to better understand our planning system, because this competition pressures us to do better than our regular planning activity. Hope to see this event organize in the future
Include evaluators from all part of the world, at least from most participating countries.
Thank you
A lot of thanks for this hard work
Thank you for this work.
Thanks for the organization of this competition!
Good job. Thank you ;)
Thank you for this competition, very interesting to participate to this event.
This is a great way to get the world looking together at one specific problem we face in the clinic. A competition can bring out the best in people which will ultimately be the best for a patient. Thank you for organizing this event and for sharing all the knowledge gained from it.
See you next year :)   thank you at all organizers for excellent job


This is good thing we hope we can create guide line for every type cancer I am ready to participate next year good luck  
Very well organized! Thumbs up! Thanks for the hard work, that was a lot of plans to evaluate.  
  Thank you for this nice idea, i hope for the next competition we will be thousand participants!
Dear organizers, Thank you very much for organising this kind of competition, it will definetly promote the planner to next level and they come to know whether they are doing best or need to improve their planning. Thank you,  
  Good Effort...Good Job...Good Service..spent More Patience for Patients..Good Luck to continue in upcoming year..Thanks for given a wonderful opportunity..
I think it was a good initiative Ahmed Nobah done good job to improve the quality of treatment plan in this region.
Thank you so much for the initiative in promoting such event. I believe that this type of thing promote the sharing of knowledge even better than conventional congress and conferences. Thank you for your time.  
As I said earlier it was very pleasant to communicate with Ahmad ,he gave very quick and clear answers to my questions. And it was very intresting to take part in such competition. I think it is very useful for planners for improving their skills. Thank you very much!I hope that soon i will take part in another competition dedicateted to another clinical case (head and neck ,for me, will be the best :-))
This was a awesome test. Thank you for this initiative!
Such a competition is a wondeful way to improve our skills, and so the treatment for our patients. Keep up the great work, I guess its required a lot of effort and time to organize it. Thank you again,  
  The competition, the organization and the idea itself are absolutely great. Looking forward for the next year!
I would like to thank Ahmad Nobah for his patience and kindness. It was very nice to plan this case since we don't do breast cases at our clinical center.
Thank you for this excellent organization. Informations given to participants were very clear. The clinical goals were well thoughtful.  
just one word : PERFECT Thank you for organizing this event. Organizers are doing good.
Thank you all for this kind of competition, The idea is unique and brilliant, Go ahead.  
  Thank-you for your dedication and hard work to help colleagues everywhere improve their skillset.
Thank you for giving me this chance Thank you for the opportunity and experience. Hugs Thank you very much!
All the organizers did a great job. Was a wonderful idea, and the commitment for the cause was full.  
  Very good communication with participant, appreciate the idea of initiating & organizing such a competition. Good work.
Ahmad did a great job. Thanks for organizing this competition. To thank Ahmad Nobah for his patience, kindness and hard work!
Great first effort! I would try and collaborate with other challenge creators to get their input.  
  I would like to congratulate the idea, the excellent organization and support that you have shown. I hope that you repeat the initiative soon. Thanks
Ahmad did a great job. Thanks for organizing this competition. Constraints are not clear simple tabular column will do to explain the need Nil
  I feel the organisers have done the best plan out of all and scored 100%.I would like to thank Mr.Ahmed for his wonderful work.
Thank you. A great opportunity to challenge and improve our planning skills
  Excellent idea to bring the wider community together  
Many thanks for this competition it is a really good idea to show our work around the world. I stand for the next competition and I hope that will be head and neck localisation :-)  

I don’t know what to say to all of you

All the hard work and the tough time we all have gone through is just turned out to be the sweetest moments, as we are now one team and one spirit all moving towards one goal:

Improving the plan quality provided to our radiotherapy patients
Think of how many lives we are saving
Think of how many people we are improving their quality of life

Evaluation Responses
Participant's Suggestion & Comments
  • How to compare plans for which the time spent is not the same.. ?
  • If this is a planning competition then as an organizer you should not accept submission of plan beyond the deadline, as it came to my notice that some planners have submitted multiple plans even after the deadline if they got good results later. As other planners who have stopped planning can also improve their results if it is announced earlier that you are accepting plans even after deadlines too.
Answer: Thank you for your comments.  Some planners spent two weeks on the plan. It is not fair to accept their late submission. Other planners, who knoew about the competition only a day or two before the deadline, should be given few extra days to finish their plan J

  • It would be very useful to be able to score my plan online before submitting. It takes significant time to just manually add up the results to compare my iterations.
  • My suggestion is to provide participants with IQ plan (demo version, if it is possible) to facilitate the evaluation of plans for competition by themselves. And in my opinion it will be better to give constraints closer to clinical situations. For example, the constraint for right breast was too hard and in clinic we don't have such hard constraints (it is not so important). Organization was at excellent level, it was very pleasant to communicate with Ahmad :-)
  • The plan criteria can be summarize a more compact way so its easy for planner to refer.
  • Constraints are confusing.. simple Tabular column would be sufficient
  • It should be great to have at least an excel file allowing us to know our score during the planning by filling in the dose constraints we manage to get. I don't know if you will give us this information, but it could be very informative to have the anonymized RT plan, RT dose, RT Structures and optimization constraints of the fifth best plans to improve our clinic.
Answer: Next competition will have a dedicated website, through which participants can submit their trials many times and get their scores before the final submission. The format was from the PlanIQ software, it is not confusing but you need to spend some time to understand it, as it will be difficult to distinguish the small differences among participants without such accurate representation of the constraints.

  • The organizers should not depend on a single person for the entire process and there should never be a single window approach for any competition, as it questions the faith on the evaluation process.
Answer: You are absolutely right. The next competition will have referees and organizers from different countries to facilitate managing such a big event.

  • I think there should be extra time allocated for the planning because of our everyday clinical work which has to be done first. But you have already asked that ;)
  • Unfortunetly I didn't have time enough to finish my planning. The plan became able to be downloaded in a very big holiday in Brazil, so I was traveling. But anyhow it was realy good to participate of that competition. I learned a lot when I was planning and I'll learn still more on the webinars.
  • There is usually long pubic hoilday during late Jan to Early Feb for China and Hong Kong region (Lunar New Year) It is difficult to attend competition for Chinese planner.
Answer: Yes we decided to allocate 3 weeks for planning the 2017 competition. We will try to make it in a time that will avoid occasions of all cultures worldwide.

  • Give some absolute limits for couch isocentric rotation (not just saying avoid collision).

Answer:  I think this is difficult.

  • We had problem in downloading images from dropbox which is not allowed in UK based clinics. Its really hard to go out of way and get the images into system. Getting time in planning is tough though with heavy workloads. There are other ways to transfer the images or may be it could send across to clinics. Unfortunately, we couldn't participate due to staff availability at the time of competition proposed and internal IT issue of transferring into system. It might be surprising, still the old school exists. Choice adds a flavour.
Answer:  I am sorry for what you have gone through, even planners from China had the same problem, this is why and as I mentioned above, the coming competition will have a dedicated website to for uploading and downloading the plans.

  • We have a good experience of plan challenges in my centre, and we always have the same issue: We would never do in our clinic what we have to do to meet the plan criteria. This includes: - Tweaking the machine model to improve gradients, etc. - Spending the two weeks almost full time on the plan challenge - Manually moving MLC leaves - Making a very complex plan (too many arcs or beams, too many segments) - Making a plan we know would not pass our patient-specific QA test For this challenge, I produced a real plan. We may not threat breasts in VMAT with 2 partial arcs, but I am fairly confident my plan would pass QA test. I did not tweak the model and did not relax and planning constrain parameter. In my clinic, we always ask ourselves jokingly "Would you treat your mother with this plan?" Here, I can say with confidence "yes, I would." You say in your email, that the best score is 98.2%; I really doubt that plan would be clinically deliverable.
  • Unfortunately, with clinical cases and in house research on-going, time for any extra activity if not planned in advance is limited and therefore little time was given to the competition. This did not allow me to explore new ways of "adjusting constraints" in the system. Nevertheless though I say I did not improve my skills it has been beneficial in terms of internal discussions between colleagues and for introducing the idea of new planning procedures. Thanks

Answer:  Thank you for your time and nice comments. The experience gained through the days to achieve a great plan quality will teach planner workarounds that will surely help them in future cases, and will try to produce also “practical and deliverable” plans as well. Hopefully next time you will have enough time as the coming planning time allocated will be 3 weeks to submit your final plan.

  • I didn't hear about the challenge till 2 days before the deadline. I would have loved to spend more time on this but with clinical duties could not. Many colleagues of mine would have done a plan too if we heard about the event sooner. I never saw the event advertised, so maybe send out some announcements for the USA. In general I enjoy doing these competitions and the interactions with Ahmad were helpful and he responded very quickly to questions, even though he was on the other side of the world.
  • More advertising of the competition. In order to save printed paper, a summary with VOI limita and máximum punctuation if achieved.
  • I did know about the competition late, so advertising it more would be great!
  • I'm not sure if it requires a modification but I did not hear about the competition until late, around 1 week or so before the deadline. If there's any way to get the word out earlier, that would be helpful.
  • To inform physicists of the existence of the next competitions, it might be judicious to go through the national medical physics societies (for exemple, NCS for Netherlands).
  • Except the time required to Plan. All other things are wonderfully done.

Answer:  Thank you for your time and nice comment. The experience gained through the days to achieve a great plan quality will teach planner workarounds that will surely help them in future. I tried my best to advertise it, we used physics list, dosimetry list, linkedin, facebook, even we contacted medical physics societies in different countries, but we promise next time to announce it in a better way J

  • Turning it into a competition with a final, semi final,... But use different localisation to show we can be good on various sites and tumors, to show adaptability to situations indicate the prescription of sites and doses
Answer:  It is a great suggestion, thank you. But planners worldwide will have heavy clinical load to participate in such a long competition J

  • Actually I have problem in sending plan I hope you have time to tell us about properties of folder that contain plan and ct Best regards
  • Unfortunately our hospital has blocked cloud services like dropbox, so in the future it could be difficult for us to participate without a plan B.
  • greater allocation of evalution point return transfer with "wetransfer" and no drupbox
  • I dont know how will be the evaluation. But I think u can have ranks by planning system, machines.... I Think that website must be improved. User friendly.
Answer:  Next competition, we will have a dedicated (user-friendly) website for our competition, through which every participant will log in and upload or download his plan and get it evaluated in less than one or two hours max before the final submission.

  • Congratulations, continue your Good work
Answer:  Thanks

  • Make categories according to the irradiation technique (IMRT - VMAT - tomo...)
  • Machine limitations and/or the TPS' physical machine model will strongly influence results. Maybe results should be compared/grouped by accelerator class and not only by treatment technique types.
  • plan evaluation criteria should also depend upon the linear accelerator on which plan is being made as size of MLC, machine head properties also degrade the plan quality. Different TPS's have different limitation for the planners so evaluating the plan by neglecting these points is not fair.
  • I think it will be better if all planners have the same linac configuration in order to really compare the skill to make plans.
Answer:  These are good suggestions, but they are difficult to implement, we will try.

  • Competition results should be announced as earlier as possible
Answer:  We will try our best in the next one

  • If possible, accept hybrid plans (i.e 3D+Imrt... ) in the evaluation.
Answer:  Many hybrid plans were submitted, but they did not do well compared to pure techniques (only IMRT or VMAT)

  • Perhaps have a stricter planning guideline. e.g. one competition to only use 3DCRT and one to only use inverse technique. This way skill can be tested, not the planning system level.
Answer:  Thank you, very valid point.

  • Competition is well organised, I would like to suggest to follow the planned dates like, start date, completion date, evaluation date & result day. I understand this is your first ever competition organized, but this is a suggestion.
Answer:  Thank you, very valid point, next one will be more organized

  • When trying to achieve a point here or there, one sometimes loses the clinical picture. It is important to stress that. I think the metric values were a little mismatched here. There should be min goals to be accepted. In this case a 70 could be achieved by doing nothing.
Answer:  Very valid point, we surely will improve our competition with considering such good suggestion to modify the constraints to the better, thank you

  • The focus of the competition should be on creating real clinical plans and not idealistied plans which no one would ever irradiate. I thing this should be a must criteria for the next competition.
Answer:  Thank you, I agree with you, but the best plans were really realistic, in terms of deliverability and accuracy, treatment times were 2-4 min for 90% of the top 15 scores, which shows they are really generating practical and efficient high quality plans. Also QA results submitted by many of the top planners shows that they are really deliverable.

  • The points of the objectives could be more realistic in terms of the clinical importance of each organ at risk. For example, lung or heart should have many more points than contralateral breast, on this case.
Answer:  Thank you. But there are other organs that are also important, and the weighting of the importance was reviewed by Rad. Onc. Consultants.

  • Dont compare the plan results with tomo, cyberknife with LINAC. Which done was a (***) results
Answer:  Most available modalities can be used to treat any site, this is why they should be put beside each other to find out the pros and cons of everyone. Other specialized modalities (i.e. CK) is a different story and I agree with you in this point. Next competition will have SBRT component to include all SBRT modalities and treatment time constrain should be included for fairness.

  • More notice for the live webinar would be beneficial to ensure people can organise themselves to participate. Approximately 1 week would be good. Thank you.
Answer:  I agree with you, will do that

  • Plan techniques much important for overall result. So try to compare same technique plans
Answer:  I agree with you, will do that, this is the plan actually is to prepare a document that will include the summary of best plans with the tips and tricks of the highest planners.

  • I was a bit disapointed that i can't send my plan because i did not receive the link to upload my plan. I have send you an e-mail on this problem but i neveu receive a feed-back...
Answer:  I am really so sorry for that, I would have responded right away in case you have sent me an email, but this is truly my mistake that I should have checked.

  • It would be better to get all information about the next competition, about files we need to upload and everything else earlier. To make it easier to transfer and communicate.
Answer:  This is a great suggestion, we surely will do that, we will start announcing at least two months earlier and will make sure that the whole process will be very simple

  • I think that the competition need more publicity to improve number of participants and increase level of results. Maybe the solution is to present this competition on mains physicist's congresses.
Answer:  I agree with you, I already contacted many medical physics societies, some responded very well, but next time we will surely make sure more will notified early enough

  • The informative webinars should be recorded and made easily available . That is the learning process and is the most beneficial part of this competition but I found it dificult to attend them due to different time zone. Please provide access to the recorded webinars of the 3 d plan winner and other plan winners
Answer:  Surely this will happen, and also a document will be prepared and sent to all interested planners worldwide to share the knowledge of the best planners.

  • It was great experience Looking next competition Thank you very much

Answer:  It is our pleasure to have you and all other planners among us



For more information, please contact: Ahmad Nobah,