National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuannanli, Chaoyang District, Beijing, 100021, China.
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Med Phys. 2019 May;46(5):1972-1983. doi: 10.1002/mp.13490. Epub 2019 Mar 30.
To develop a deep learning method for prediction of three-dimensional (3D) voxel-by-voxel dose distributions of helical tomotherapy (HT).
Using previously treated HT plans as training data, a deep learning model named U-ResNet-D was trained to predict a 3D dose distribution. First, the contoured structures and dose volumes were converted from plan database to 3D matrix with a program based on a developed visualization toolkit (VTK), then transferred to U-ResNet-D for correlating anatomical features and dose distributions at voxel-level. One hundred and ninety nasopharyngeal cancer (NPC) patients treated by HT with multiple planning target volumes (PTVs) in different prescription patterns were studied. The model was typically trained from scratch with weights randomly initialized rather than using transfer-learning method, and used to predict new patient's 3D dose distributions. The predictive accuracy was evaluated with three methods: (a) The dose difference at the position r, δ(r, r) = D (r) - D (r), was calculated for each voxel. The mean (μ ) and standard deviation (σ ) of δ(r, r) were calculated to assess the prediction bias and precision; (b) The mean absolute differences of dosimetric indexes (DIs) including maximum and mean dose, homogeneity index, conformity index, and dose spillage for PTVs and organ at risks (OARs) were calculated and statistically analyzed with the paired-samples t test; (c) Dice similarity coefficients (DSC) between predicted and clinical isodose volumes were calculated.
The U-ResNet-D model predicted 3D dose distribution accurately. For twenty tested patients, the prediction bias ranged from -2.0% to 2.3% and prediction error varied from 1.5% to 4.5% (relative to prescription) for 3D dose differences. The mean absolute dose differences for PTVs and OARs are within 2.0% and 4.2%, and nearly all the DIs for PTVs and OARs had no significant differences. The averaged DSC ranged from 0.95 to 1 for different isodose volumes.
The study developed a new deep learning method for 3D voxel-by-voxel dose prediction, and shown to be able to produce accurately dose predictions for nasopharyngeal patients treated by HT. The predicted 3D dose map can be useful for improving radiotherapy planning design, ensuring plan quality and consistency, making clinical technique comparison, and guiding automatic treatment planning.
开发一种用于预测螺旋断层放疗(HT)三维(3D)体素剂量分布的深度学习方法。
使用已治疗的 HT 计划作为训练数据,训练一种名为 U-ResNet-D 的深度学习模型来预测 3D 剂量分布。首先,将轮廓结构和剂量体积从计划数据库转换为基于开发的可视化工具包(VTK)的 3D 矩阵,然后将其传输到 U-ResNet-D 以在体素水平上关联解剖特征和剂量分布。研究了 190 名接受 HT 治疗的鼻咽癌(NPC)患者,这些患者的多个计划靶区(PTV)采用不同的处方模式。该模型通常是从头开始训练的,权重是随机初始化的,而不是使用迁移学习方法,用于预测新患者的 3D 剂量分布。使用三种方法评估预测准确性:(a)对于每个体素,计算位置 r 处的剂量差异,δ(r,r)= D(r)-D(r)。计算δ(r,r)的均值(μ)和标准差(σ),以评估预测偏差和精度;(b)计算包括 PTV 和危及器官(OAR)的最大和平均剂量、均匀性指数、适形性指数和剂量泄漏的剂量学指标(DI)的平均绝对差异,并使用配对样本 t 检验进行统计学分析;(c)计算预测和临床等剂量体积之间的 Dice 相似系数(DSC)。
U-ResNet-D 模型能够准确地预测 3D 剂量分布。对于 20 名测试患者,3D 剂量差异的预测偏差范围为-2.0%至 2.3%,预测误差范围为 1.5%至 4.5%(相对于处方)。PTV 和 OAR 的平均绝对剂量差异在 2.0%和 4.2%之间,几乎所有 PTV 和 OAR 的 DI 均无显著差异。不同等剂量体积的平均 DSC 范围为 0.95 至 1。
本研究开发了一种新的用于 3D 体素剂量预测的深度学习方法,能够为接受 HT 治疗的鼻咽癌患者准确地预测剂量。预测的 3D 剂量图可用于改进放疗计划设计,确保计划质量和一致性,进行临床技术比较,并指导自动治疗计划。