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Fionda B, Placidi E, de Ridder M, Strigari L, Patarnello S, Tanderup K, Hannoun-Levi JM, Siebert FA, Boldrini L, Antonietta Gambacorta M, De Spirito M, Sala E, Tagliaferri L. Artificial intelligence in interventional radiotherapy (brachytherapy): Enhancing patient-centered care and addressing patients' needs. Clin Transl Radiat Oncol 2024; 49:100865. [PMID: 39381628 PMCID: PMC11459626 DOI: 10.1016/j.ctro.2024.100865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 09/11/2024] [Accepted: 09/20/2024] [Indexed: 10/10/2024] Open
Abstract
This review explores the integration of artificial intelligence (AI) in interventional radiotherapy (IRT), emphasizing its potential to streamline workflows and enhance patient care. Through a systematic analysis of 78 relevant papers spanning from 2002 to 2024, we identified significant advancements in contouring, treatment planning, outcome prediction, and quality assurance. AI-driven approaches offer promise in reducing procedural times, personalizing treatments, and improving treatment outcomes for oncological patients. However, challenges such as clinical validation and quality assurance protocols persist. Nonetheless, AI presents a transformative opportunity to optimize IRT and meet evolving patient needs.
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Affiliation(s)
- Bruno Fionda
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Elisa Placidi
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Mischa de Ridder
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Patarnello
- Real World Data Facility, Gemelli Generator, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Kari Tanderup
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jean-Michel Hannoun-Levi
- Department of Radiation Oncology, Antoine Lacassagne Cancer Centre, University of Côte d’Azur, Nice, France
| | - Frank-André Siebert
- Clinic of Radiotherapy (Radiooncology), University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Luca Boldrini
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Maria Antonietta Gambacorta
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco De Spirito
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Evis Sala
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tagliaferri
- Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Chen J, Qiu RL, Wang T, Momin S, Yang X. A Review of Artificial Intelligence in Brachytherapy. ARXIV 2024:arXiv:2409.16543v1. [PMID: 39398213 PMCID: PMC11469420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
Artificial intelligence (AI) has the potential to revolutionize brachytherapy's clinical workflow. This review comprehensively examines the application of AI, focusing on machine learning and deep learning, in facilitating various aspects of brachytherapy. We analyze AI's role in making brachytherapy treatments more personalized, efficient, and effective. The applications are systematically categorized into seven categories: imaging, preplanning, treatment planning, applicator reconstruction, quality assurance, outcome prediction, and real-time monitoring. Each major category is further subdivided based on cancer type or specific tasks, with detailed summaries of models, data sizes, and results presented in corresponding tables. This review offers insights into the current advancements, challenges, and the impact of AI on treatment paradigms, encouraging further research to expand its clinical utility.
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Affiliation(s)
- Jingchu Chen
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30308
- School of Mechanical Engineering, Georgia Institute of Technology, GA, Atlanta, USA
| | - Richard L.J. Qiu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30308
| | - Tonghe Wang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065
| | - Shadab Momin
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30308
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30308
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Fechter T, Sachpazidis I, Baltas D. The use of deep learning in interventional radiotherapy (brachytherapy): A review with a focus on open source and open data. Z Med Phys 2024; 34:180-196. [PMID: 36376203 PMCID: PMC11156786 DOI: 10.1016/j.zemedi.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
Deep learning advanced to one of the most important technologies in almost all medical fields. Especially in areas, related to medical imaging it plays a big role. However, in interventional radiotherapy (brachytherapy) deep learning is still in an early phase. In this review, first, we investigated and scrutinised the role of deep learning in all processes of interventional radiotherapy and directly related fields. Additionally, we summarised the most recent developments. For better understanding, we provide explanations of key terms and approaches to solving common deep learning problems. To reproduce results of deep learning algorithms both source code and training data must be available. Therefore, a second focus of this work is on the analysis of the availability of open source, open data and open models. In our analysis, we were able to show that deep learning plays already a major role in some areas of interventional radiotherapy, but is still hardly present in others. Nevertheless, its impact is increasing with the years, partly self-propelled but also influenced by closely related fields. Open source, data and models are growing in number but are still scarce and unevenly distributed among different research groups. The reluctance in publishing code, data and models limits reproducibility and restricts evaluation to mono-institutional datasets. The conclusion of our analysis is that deep learning can positively change the workflow of interventional radiotherapy but there is still room for improvements when it comes to reproducible results and standardised evaluation methods.
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Affiliation(s)
- Tobias Fechter
- Division of Medical Physics, Department of Radiation Oncology, Medical Center University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany.
| | - Ilias Sachpazidis
- Division of Medical Physics, Department of Radiation Oncology, Medical Center University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Dimos Baltas
- Division of Medical Physics, Department of Radiation Oncology, Medical Center University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
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Zhao JZ, Ni R, Chow R, Rink A, Weersink R, Croke J, Raman S. Artificial intelligence applications in brachytherapy: A literature review. Brachytherapy 2023; 22:429-445. [PMID: 37248158 DOI: 10.1016/j.brachy.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/02/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Artificial intelligence (AI) has the potential to simplify and optimize various steps of the brachytherapy workflow, and this literature review aims to provide an overview of the work done in this field. METHODS AND MATERIALS We conducted a literature search in June 2022 on PubMed, Embase, and Cochrane for papers that proposed AI applications in brachytherapy. RESULTS A total of 80 papers satisfied inclusion/exclusion criteria. These papers were categorized as follows: segmentation (24), registration and image processing (6), preplanning (13), dose prediction and treatment planning (11), applicator/catheter/needle reconstruction (16), and quality assurance (10). AI techniques ranged from classical models such as support vector machines and decision tree-based learning to newer techniques such as U-Net and deep reinforcement learning, and were applied to facilitate small steps of a process (e.g., optimizing applicator selection) or even automate the entire step of the workflow (e.g., end-to-end preplanning). Many of these algorithms demonstrated human-level performance and offer significant improvements in speed. CONCLUSIONS AI has potential to augment, automate, and/or accelerate many steps of the brachytherapy workflow. We recommend that future studies adhere to standard reporting guidelines. We also stress the importance of using larger sample sizes and reporting results using clinically interpretable measures.
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Affiliation(s)
- Jonathan Zl Zhao
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ruiyan Ni
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Ronald Chow
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Alexandra Rink
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Robert Weersink
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Jennifer Croke
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Srinivas Raman
- Princess Margaret Hospital Cancer Centre, Radiation Medicine Program, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
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