Abstract
Background: Volumetric modulated arc therapy (VMAT) planning is a time-consuming process of radiation therapy. With a deep learning approach, 3D dose distribution can be predicted without the need for an actual dose calculation. This approach can accelerate the process by guiding and confirming the achievable dose distribution in order to reduce the replanning iterations while maintaining the plan quality. Methods: In this study, three dose distribution predictive models of VMAT for prostate cancer were developed, evaluated, and compared. Each model was designed with a different input data structure to train and test the model: (1) patient CT alone (PCT alone), (2) patient CT and generalized organ structure (PCTGOS), and (3) patient CT and specific organ structure (PCTSOS). The generative adversarial network (GAN) model was used as a core learning algorithm. The models were trained slice-by-slice using 46 VMAT plans for prostate cancer, and then used to predict and evaluate the dose distribution from 8 independent plans. Results: VMAT dose distribution was generated with a mean prediction time of approximately 3.5 s per patient, whereas the PCTSOS model was excluded due to a mean prediction time of approximately 17.5 s per patient. The highest average 3D gamma passing rate was 80.51 ± 5.94, while the lowest overall percentage difference of dose-volume histogram (DVH) parameters was 6.01 ± 5.44% for the prescription dose from the PCTGOS model. However, the PCTSOS model was the most reliable for the evaluation of multiple parameters. Conclusions: This dose prediction model could accelerate the iterative optimization process for the planning of VMAT treatment by guiding the planner with the desired dose distribution.
Highlights
Prostate cancer was the second most diagnosed cancer and the fifth leading cause of death among the male population globally in 2020 [1]
In Volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT), the complex dose distribution can increase the dose conformity to the target and significantly decrease the amount of dose given to the organs at risk (OARs), which can reduce the risk of complications to normal tissues after treatment [4]; in order to achieve a higher complex dose distribution, the complexity of the treatment planning process is increased [4,5]
The results show that the dose differences evaluated by the dose-volume histogram (DVH) parameters are approximately 2% of the prescription dose for planning target volume (PTV) and 3% for
Summary
Prostate cancer was the second most diagnosed cancer and the fifth leading cause of death among the male population globally in 2020 [1]. Volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) are widely used, and have become the standard for prostate cancer treatments in many institutes [2,3]. In VMAT and IMRT, the complex dose distribution can increase the dose conformity to the target and significantly decrease the amount of dose given to the organs at risk (OARs), which can reduce the risk of complications to normal tissues after treatment [4]; in order to achieve a higher complex dose distribution, the complexity of the treatment planning process is increased [4,5]. In order to achieve the desired dose distribution, the dosimetrist or the planner has to manually input the optimized parameters to the treatment planning system (TPS). The system will calculate and evaluate the dose distribution outcome through dose prescription and dose criteria via planning target volume (PTV) and OARs, respectively. The process may be iterated from an unapproved plan, and more requirements may be needed from the radiation oncologist’s perspective
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