Faculty, Staff and Student Publications
Publication Date
11-1-2023
Journal
Medical Physics
Abstract
Background: In recent years, deep‐learning models have been used to predict entire three‐dimensional dose distributions. However, the usability of dose predictions to improve plan quality should be further investigated.
Purpose: To develop a deep‐learning model to predict high‐quality dose distributions for volumetric modulated arc therapy (VMAT) plans for patients with gynecologic cancer and to evaluate their usability in driving plan quality improvements.
Methods: A total of 79 VMAT plans for the female pelvis were used to train (47 plans), validate (16 plans), and test (16 plans) 3D dense dilated U‐Net models to predict 3D dose distributions. The models received the normalized CT scan, dose prescription, and target and normal tissue contours as inputs. Three models were used to predict the dose distributions for plans in the test set. A radiation oncologist specializing in the treatment of gynecologic cancers scored the test set predictions using a 5‐point scale (5, acceptable as‐is; 4, prefer minor edits; 3, minor edits needed; 2, major edits needed; and 1, unacceptable). The clinical plans for which the dose predictions indicated that improvements could be made were reoptimized with constraints extracted from the predictions.
Results: The predicted dose distributions in the test set were of comparable quality to the clinical plans. The mean voxel‐wise dose difference was −0.14 ± 0.46 Gy. The percentage dose differences in the predicted target metrics of D1% and D98% were −1.05% ± 0.59% and 0.21% ± 0.28%, respectively. The dose differences in the predicted organ at risk mean and maximum doses were −0.30 ± 1.66 Gy and −0.42 ± 2.07 Gy, respectively. A radiation oncologist deemed all of the predicted dose distributions clinically acceptable; 12 received a score of 5, and four received a score of 4. Replanning of flagged plans (five plans) showed that the original plans could be further optimized to give dose distributions close to the predicted dose distributions.
Conclusions: Deep‐learning dose prediction can be used to predict high‐quality and clinically acceptable dose distributions for VMAT female pelvis plans, which can then be used to identify plans that can be improved with additional optimization.
Keywords
Humans, Female, Radiotherapy Dosage, Deep Learning, Radiotherapy, Intensity-Modulated, Radiotherapy Planning, Computer-Assisted, Neoplasms, Organs at Risk, artificial intelligence, deep learning, dose prediction, quality assurance
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Health and Medical Physics Commons, Medical Sciences Commons, Oncology Commons
Comments
Supplementary Materials
PMID: 37706560