Abstract

PurposeThis study proposes a cascaded network model for generating high-resolution doses (i.e., a 1 mm grid) from low-resolution doses (i.e., ≥3 mm grids) with reduced computation time.MethodsUsing the anisotropic analytical algorithm with three grid sizes (1, 3, and 5 mm) and the Acuros XB algorithm with two grid sizes (1 and 3 mm), dose distributions were calculated for volumetric modulated arc therapy plans for 73 prostate cancer patients. Our cascaded network model consisted of a hierarchically densely connected U-net (HD U-net) and a residual dense network (RDN), which were trained separately following a two-dimensional slice-by-slice procedure. The first network (HD U-net) predicted the downsampled high-resolution dose (generated through bicubic downsampling of the baseline high-resolution dose) using the low-resolution dose; subsequently, the second network (RDN) predicted the high-resolution dose from the output of the first network. Further, the predicted high-resolution dose was converted to its absolute value. We quantified the network performance using the spatial/dosimetric parameters (dice similarity coefficient, mean dose, maximum dose, minimum dose, homogeneity index, conformity index, and V95%, V70%, V50%, and V30%) for the low-resolution and predicted high-resolution doses relative to the baseline high-resolution dose. Gamma analysis (between the baseline dose and the low-resolution dose/predicted high-resolution dose) was performed with a 2%/2 mm criterion and 10% threshold.ResultsThe average computation time to predict a high-resolution axial dose plane was <0.02 s. The dice similarity coefficient values for the predicted doses were closer to 1 when compared to those for the low-resolution doses. Most of the dosimetric parameters for the predicted doses agreed more closely with those for the baseline than for the low-resolution doses. In most of the parameters, no significant differences (p-value of >0.05) between the baseline and predicted doses were observed. The gamma passing rates for the predicted high-resolution does were higher than those for the low-resolution doses.ConclusionThe proposed model accurately predicted high-resolution doses for the same dose calculation algorithm. Our model uses only dose data as the input without additional data, which provides advantages of convenience to user over other dose super-resolution methods.

Highlights

  • Volumetric modulated arc therapy (VMAT) delivers radiation doses, with variable dose rate, continuously via the dynamic movement of gantry/multileaf collimator (MLC) leaves, and is capable of delivering highly conformal prescription doses to the target while minimizing to the exposure for organs at risks (OARs) [1,2,3,4].The advantages of VMAT are that it has fewer monitor unit requirements and a shorter delivery time compared to intensity modulated radiation therapy (IMRT)

  • Several previous studies have reported that dose grid size is related to the accuracy of dose calculations using the analytical algorithm (AAA) and the Acuros XB (AXB) algorithms in VMAT/IMRT plans. [13,14,15,16,17,18,19] With film/ Monte Carlo evaluations, Gagne et al [13] showed that AAA dose calculations with a 5 mm grid caused >2% dosimetric error than those with finer grids (≤ 2.5 mm) in a simple RapidArc plan

  • We reported the computation times for the AAA and the AXB algorithm according to grid sizes in prostate VMAT plans (AAA with a 1 mm grid: 2,211 ± 155 s, AAA with a 3 mm grid: 245 ± 27 s, AAA with a 5 mm grid: 130 ± 10 s, AXB with a 1 mm grid: 4061 ± 922 s, AXB with a 2 mm grid: 671 ± 91 s, AXB with a 3 mm grid: 262 ± 26 s) in a previous study [22]

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Summary

Introduction

Volumetric modulated arc therapy (VMAT) delivers radiation doses, with variable dose rate, continuously via the dynamic movement of gantry/multileaf collimator (MLC) leaves, and is capable of delivering highly conformal prescription doses to the target while minimizing to the exposure for organs at risks (OARs) [1,2,3,4].The advantages of VMAT are that it has fewer monitor unit requirements and a shorter delivery time compared to intensity modulated radiation therapy (IMRT). Through gamma evaluation of the IMRT plan for head and neck patients, Srivastava et al [17] found that doses based on the AAA with a 1 mm grid showed closest agreement with the measured doses (by film) compared to AAA dose calculations for several grid sizes (2, 3, 4, and 5 mm). Their findings indicated that use of a 1 mm grid is essential for treating head and neck patients via the IMRT plan because of small OARs involved, for example, optic nerve and cochlea. Chow et al [18, 19] showed there were variations of dose volume parameters and radiobiological parameters on planning target volume (PTV), rectal wall, and rectum according to changes of grid sizes (from 1 to 5 mm with 1 mm intervals) using AAA calculation in prostate VMAT plan

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