Abstract
Purpose:The predictive power of knowledge based planning (KBP) has considerable potential in the development of automated treatment planning. Here, we examine the predictive capabilities and accuracy of previously reported KBP methods, as well as an artificial neural networks (ANN) method. Furthermore, we compare the predictive accuracy of these methods on coplanar volumetric‐modulated arc therapy (VMAT) and non‐coplanar 4π radiotherapy.Methods:30 liver SBRT patients previously treated using coplanar VMAT were selected for this study. The patients were re‐planned using 4π radiotherapy, which involves 20 optimally selected non‐coplanar IMRT fields. ANNs were used to incorporate enhanced geometric information including liver and PTV size, prescription dose, patient girth, and proximity to beams. The performance of ANN was compared to three methods from statistical voxel dose learning (SVDL), wherein the doses of voxels sharing the same distance to the PTV are approximated by either taking the median of the distribution, non‐parametric fitting, or skew‐normal fitting. These three methods were shown to be capable of predicting DVH, but only median approximation can predict 3D dose. Prediction methods were tested using leave‐one‐out cross‐validation tests and evaluated using residual sum of squares (RSS) for DVH and 3D dose predictions.Results:DVH prediction using non‐parametric fitting had the lowest average RSS with 0.1176(4π) and 0.1633(VMAT), compared to 0.4879(4π) and 1.8744(VMAT) RSS for ANN. 3D dose prediction with median approximation had lower RSS with 12.02(4π) and 29.22(VMAT), compared to 27.95(4π) and 130.9(VMAT) for ANN.Conclusion:Paradoxically, although the ANNs included geometric features in addition to the distances to the PTV, it did not perform better in predicting DVH or 3D dose compared to simpler, faster methods based on the distances alone. The study further confirms that the prediction of 4π non‐coplanar plans were more accurate than VMAT.NIH R43CA183390 and R01CA188300
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