1
|
Zhang H, Yu Y, Zhang F. Prediction of dose distributions for non-small cell lung cancer patients using MHA-ResUNet. Med Phys 2024. [PMID: 39024495 DOI: 10.1002/mp.17308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 06/08/2024] [Accepted: 06/29/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The current level of automation in the production of radiotherapy plans for lung cancer patients is relatively low. With the development of artificial intelligence, it has become a reality to use neural networks to predict dose distributions and provide assistance for radiation therapy planning. However, due to the significant individual variability in the distribution of non-small cell lung cancer (NSCLC) planning target volume (PTV) and the complex spatial relationships between the PTV and organs at risk (OARs), there is still a lack of a high-precision dose prediction network tailored to the characteristics of NSCLC. PURPOSE To assist in the development of volumetric modulated arc therapy (VMAT) plans for non-small cell lung cancer patients, a deep neural network is proposed to predict high-precision dose distribution. METHODS This study has developed a network called MHA-ResUNet, which combines a large-kernel dilated convolution module and multi-head attention (MHA) modules. The network was trained based on 80 VMAT plans of NSCLC patients. CT images, PTV, and OARs were fed into the independent input channel. The dose distribution was taken as the output to train the model. The performance of this network was compared with that of several commonly used networks, and the networks' performance was evaluated based on the voxel-level mean absolute error (MAE) within the PTV and OARs, as well as the error in clinical dose-volume metrics. RESULTS The MAE between the predicted dose distribution and the manually planned dose distribution within the PTV is 1.43 Gy, and the D95 error is less than 1 Gy. Compared with the other three commonly used networks, the dose error of the MHA-ResUNet is the smallest in PTV and OARs. CONCLUSIONS The proposed MHA-ResUNet network improves the receptive field and filters the shallow features to learn the relative spatial relation between the PTV and the OARs, enabling accurate prediction of dose distributions in NSCLC patients undergoing VMAT radiotherapy.
Collapse
Affiliation(s)
- Haifeng Zhang
- Radiation Oncology Department, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- School of Automation Science and Electrical Engineering, Beihang University, Beijing, China
| | - Yanjun Yu
- Radiation Oncology Department, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fuli Zhang
- Radiation Oncology Department, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
2
|
Wen X, Zhao C, Zhao B, Yuan M, Chang J, Liu W, Meng J, Shi L, Yang S, Zeng J, Yang Y. Application of deep learning in radiation therapy for cancer. Cancer Radiother 2024; 28:208-217. [PMID: 38519291 DOI: 10.1016/j.canrad.2023.07.015] [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: 06/26/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 03/24/2024]
Abstract
In recent years, with the development of artificial intelligence, deep learning has been gradually applied to clinical treatment and research. It has also found its way into the applications in radiotherapy, a crucial method for cancer treatment. This study summarizes the commonly used and latest deep learning algorithms (including transformer, and diffusion models), introduces the workflow of different radiotherapy, and illustrates the application of different algorithms in different radiotherapy modules, as well as the defects and challenges of deep learning in the field of radiotherapy, so as to provide some help for the development of automatic radiotherapy for cancer.
Collapse
Affiliation(s)
- X Wen
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - C Zhao
- School of Biomedical Engineering, Shanghai Jiao Tong University, No. 800, Dongchuan Road, Minhang District, Shanghai, China
| | - B Zhao
- Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - M Yuan
- Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - J Chang
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - W Liu
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - J Meng
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - L Shi
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - S Yang
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - J Zeng
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao University, Qingdao, China; School of Basic Medicine, Qingdao University, Qingdao, China
| | - Y Yang
- Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
| |
Collapse
|
3
|
Gu X, Strijbis VIJ, Slotman BJ, Dahele MR, Verbakel WFAR. Dose distribution prediction for head-and-neck cancer radiotherapy using a generative adversarial network: influence of input data. Front Oncol 2023; 13:1251132. [PMID: 37829347 PMCID: PMC10565853 DOI: 10.3389/fonc.2023.1251132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023] Open
Abstract
Purpose A three-dimensional deep generative adversarial network (GAN) was used to predict dose distributions for locally advanced head and neck cancer radiotherapy. Given the labor- and time-intensive nature of manual planning target volume (PTV) and organ-at-risk (OAR) segmentation, we investigated whether dose distributions could be predicted without the need for fully segmented datasets. Materials and methods GANs were trained/validated/tested using 320/30/35 previously segmented CT datasets and treatment plans. The following input combinations were used to train and test the models: CT-scan only (C); CT+PTVboost/elective (CP); CT+PTVs+OARs+body structure (CPOB); PTVs+OARs+body structure (POB); PTVs+body structure (PB). Mean absolute errors (MAEs) for the predicted dose distribution and mean doses to individual OARs (individual salivary glands, individual swallowing structures) were analyzed. Results For the five models listed, MAEs were 7.3 Gy, 3.5 Gy, 3.4 Gy, 3.4 Gy, and 3.5 Gy, respectively, without significant differences among CP-CPOB, CP-POB, CP-PB, among CPOB-POB. Dose volume histograms showed that all four models that included PTV contours predicted dose distributions that had a high level of agreement with clinical treatment plans. The best model CPOB and the worst model PB (except model C) predicted mean dose to within ±3 Gy of the clinical dose, for 82.6%/88.6%/82.9% and 71.4%/67.1%/72.2% of all OARs, parotid glands (PG), and submandibular glands (SMG), respectively. The R2 values (0.17/0.96/0.97/0.95/0.95) of OAR mean doses for each model also indicated that except for model C, the predictions correlated highly with the clinical dose distributions. Interestingly model C could reasonably predict the dose in eight patients, but on average, it performed inadequately. Conclusion We demonstrated the influence of the CT scan, and PTV and OAR contours on dose prediction. Model CP was not statistically different from model CPOB and represents the minimum data statistically required to adequately predict the clinical dose distribution in a group of patients.
Collapse
Affiliation(s)
- Xiaojin Gu
- Department of Radiation Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Victor I. J. Strijbis
- Department of Radiation Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Ben J. Slotman
- Department of Radiation Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Max R. Dahele
- Department of Radiation Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Wilko F. A. R. Verbakel
- Department of Radiation Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| |
Collapse
|
4
|
Poel R, Kamath AJ, Willmann J, Andratschke N, Ermiş E, Aebersold DM, Manser P, Reyes M. Deep-Learning-Based Dose Predictor for Glioblastoma-Assessing the Sensitivity and Robustness for Dose Awareness in Contouring. Cancers (Basel) 2023; 15:4226. [PMID: 37686501 PMCID: PMC10486555 DOI: 10.3390/cancers15174226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
External beam radiation therapy requires a sophisticated and laborious planning procedure. To improve the efficiency and quality of this procedure, machine-learning models that predict these dose distributions were introduced. The most recent dose prediction models are based on deep-learning architectures called 3D U-Nets that give good approximations of the dose in 3D almost instantly. Our purpose was to train such a 3D dose prediction model for glioblastoma VMAT treatment and test its robustness and sensitivity for the purpose of quality assurance of automatic contouring. From a cohort of 125 glioblastoma (GBM) patients, VMAT plans were created according to a clinical protocol. The initial model was trained on a cascaded 3D U-Net. A total of 60 cases were used for training, 15 for validation and 20 for testing. The prediction model was tested for sensitivity to dose changes when subject to realistic contour variations. Additionally, the model was tested for robustness by exposing it to a worst-case test set containing out-of-distribution cases. The initially trained prediction model had a dose score of 0.94 Gy and a mean DVH (dose volume histograms) score for all structures of 1.95 Gy. In terms of sensitivity, the model was able to predict the dose changes that occurred due to the contour variations with a mean error of 1.38 Gy. We obtained a 3D VMAT dose prediction model for GBM with limited data, providing good sensitivity to realistic contour variations. We tested and improved the model's robustness by targeted updates to the training set, making it a useful technique for introducing dose awareness in the contouring evaluation and quality assurance process.
Collapse
Affiliation(s)
- Robert Poel
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
- ARTORG Center for Biomedical Research, University of Bern, CH-3010 Bern, Switzerland
| | - Amith J. Kamath
- ARTORG Center for Biomedical Research, University of Bern, CH-3010 Bern, Switzerland
| | - Jonas Willmann
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, CH-8091 Zurich, Switzerland
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, CH-8091 Zurich, Switzerland
| | - Ekin Ermiş
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Daniel M. Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Peter Manser
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
- Division of Medical Radiation Physics, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Mauricio Reyes
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
- ARTORG Center for Biomedical Research, University of Bern, CH-3010 Bern, Switzerland
| |
Collapse
|
5
|
Yang B, Liu Y, Chen Z, Wang Z, Zhou Q, Qiu J. Tissues margin-based analytical anisotropic algorithm boosting method via deep learning attention mechanism with cervical cancer. Int J Comput Assist Radiol Surg 2023; 18:953-959. [PMID: 36460828 DOI: 10.1007/s11548-022-02801-1] [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: 06/12/2022] [Accepted: 11/19/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Speed and accuracy are two critical factors in dose calculation for radiotherapy. Analytical Anisotropic Algorithm (AAA) is a rapid dose calculation algorithm but has dose errors in tissue margin area. Acuros XB (AXB) has high accuracy but takes long time to calculate. To improve the dose accuracy on the tissue margin area for AAA, we proposed a novel deep learning-based dose accuracy improvement method using Margin-Net combined with Margin-Loss. METHODS A novel model 'Margin-Net' was designed with a Margin Attention Mechanism to generate special margin-related features. Margin-Loss was introduced to consider the dose errors and dose gradients in tissues margin area. Ninety-five VMAT cervical cancer cases with paired AAA and AXB dose were enrolled in our study: 76 cases for training and 19 cases for testing. Tissues Margin Masks were generated from RT contours with 6 mm extension. Tissues Margin Mask, AAA dose and CTs were input data; AXB dose was used as reference dose for model training and evaluation. Comparison experiments were performed to evaluated effectiveness of Margin-Net and Margin-Loss. RESULTS Compared to AXB dose, the 3D gamma passing rate (1%/1 mm, 10% threshold) for 19 test cases 95.75 ± 1.05% using Margin-Net with Margin-Loss, which was significantly higher than the original AAA dose (73.64 ± 3.46%). The passing rate reduced to 94.07 ± 1.16% without Margin-Loss and 87.3 ± 1.18% if Margin-Net key structure 'MAM' was also removed. CONCLUSION The proposed novel tissues margin-based dose conversion method can significantly improve the dose accuracy of Analytical Anisotropic Algorithm to be comparable to AXB algorithm. It can potentially improve the efficiency of treatment planning process with low demanding of computation resources.
Collapse
Affiliation(s)
- Bo Yang
- Peking Union Medical College Hospital, Beijing, 100005, China
| | - Yaoying Liu
- School of Physics, Beihang University, Beijing, 102206, China
- Manteia Technologies Co., Ltd, Xiamen, 361008, China
| | - Zhaocai Chen
- Manteia Technologies Co., Ltd, Xiamen, 361008, China
| | - Zhiqun Wang
- Peking Union Medical College Hospital, Beijing, 100005, China
| | - Qichao Zhou
- Manteia Technologies Co., Ltd, Xiamen, 361008, China.
| | - Jie Qiu
- Peking Union Medical College Hospital, Beijing, 100005, China.
| |
Collapse
|
6
|
Peng Y, Liu Y, Chen Z, Zhang G, Ma C, Xu S, Yin Y. Accuracy Improvement Method Based on Characteristic Database Classification for IMRT Dose Prediction in Cervical Cancer: Scientifically Training Data Selection. Front Oncol 2022; 12:808580. [PMID: 35311133 PMCID: PMC8927290 DOI: 10.3389/fonc.2022.808580] [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: 11/03/2021] [Accepted: 01/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Consistent training and testing datasets can lead to good performance for deep learning (DL) models. However, a large high-quality training dataset for unusual clinical scenarios is usually not easy to collect. The work aims to find optimal training data collection strategies for DL-based dose prediction models. Materials and Methods A total of 325 clinically approved cervical IMRT plans were utilized. We designed comparison experiments to investigate the impact of (1) beam angles, (2) the number of beams, and (3) patient position for DL dose prediction models. In addition, a novel geometry-based beam mask generation method was proposed to provide beam setting information in the model training process. What is more, we proposed a new training strategy named “full-database pre-trained strategy”. Results The model trained with a homogeneous dataset with the same beam settings achieved the best performance [mean prediction errors of planning target volume (PTV), bladder, and rectum: 0.29 ± 0.15%, 3.1 ± 2.55%, and 3.15 ± 1.69%] compared with that trained with large mixed beam setting plans (mean errors of PTV, bladder, and rectum: 0.8 ± 0.14%, 5.03 ± 2.2%, and 4.45 ± 1.4%). A homogeneous dataset is more accessible to train an accurate dose prediction model (mean errors of PTV, bladder and rectum: 2.2 ± 0.15%, 5 ± 2.1%, and 3.23 ± 1.53%) than a non-homogeneous one (mean errors of PTV, bladder and rectum: 2.55 ± 0.12%, 6.33 ± 2.46%, and 4.76 ± 2.91%) without other processing approaches. The added beam mask can constantly improve the model performance, especially for datasets with different beam settings (mean errors of PTV, bladder, and rectum improved from 0.8 ± 0.14%, 5.03 ± 2.2%, and 4.45 ± 1.4% to 0.29 ± 0.15%, 3.1 ± 2.55%, and 3.15 ± 1.69%). Conclusions A consistent dataset is recommended to form a patient-specific IMRT dose prediction model. When a consistent dataset is not accessible to collect, a large dataset with different beam angles and a training model with beam information can also get a relatively good model. The full-database pre-trained strategies can rapidly form an accuracy model from a pre-trained model. The proposed beam mask can effectively improve the model performance. Our study may be helpful for further dose prediction studies in terms of training strategies or database establishment.
Collapse
Affiliation(s)
- Yiru Peng
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yaoying Liu
- School of Physics, Beihang University, Beijing, China
| | | | - Gaolong Zhang
- School of Physics, Beihang University, Beijing, China
| | - Changsheng Ma
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shouping Xu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Yin
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| |
Collapse
|
7
|
Wang C, Zheng Z, Xu T, Yin Z, Chen E. Interaction-Aware Temporal Prescription Generation via Message Passing Neural Network. ARTIF INTELL 2022. [DOI: 10.1007/978-3-031-20500-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|