Medical Physics Graduate Program, Duke University, Durham, North Carolina, USA.
Medical Physics Graduate Program, Duke Kunshan University, Kunshan, China.
Med Phys. 2021 Mar;48(3):978-990. doi: 10.1002/mp.14670. Epub 2021 Jan 21.
Multileaf collimator (MLC) delivery discrepancy between planned and actual (delivered) positions have detrimental effect on the accuracy of dose distributions for both IMRT and VMAT. In this study, we evaluated the consistency of MLC delivery discrepancies over the course of treatment and over time to verify that a predictive machine learning model would be applicable throughout the course of treatment. Next, the MLC and gantry positions recorded in prior trajectory log files were analyzed to build a machine learning algorithm to predict MLC positional discrepancies during delivery for a new treatment plan. An open source tool was developed and released to predict the MLC positional discrepancies at treatment delivery for any given plan.
Trajectory log files of 142 IMRT plans and 125 VMAT plans from 9 Varian TrueBeam linear accelerators were collected and analyzed. The consistency of delivery discrepancy over patient-specific quality assurance (QA) and patient treatment deliveries was evaluated. Data were binned by treatment site and machine type to determine their relationship with MLC and gantry angle discrepancies. Motion-related parameters including MLC velocity, MLC acceleration, control point, dose rate, and gravity vector, gantry velocity and gantry acceleration, where applicable, were analyzed to evaluate correlations with MLC and gantry discrepancies. Several regression models, such as simple/multiple linear regression, decision tree, and ensemble method (boosted tree and bagged tree model) were used to develop a machine learning algorithm to predict MLC discrepancy based on MLC motion parameters.
MLC discrepancies at patient-specific QA differed from those at patient treatment deliveries by a small (mean = 0.0021 ± 0.0036 mm, P = 0.0089 for IMRT; mean = 0.0010 ± 0.0016 mm, P = 0.0003 for VMAT) but statistically significant amount, likely due to setting the gantry angle to zero for QA in IMRT. MLC motion parameters, MLC velocity and gravity vector, showed significant correlation (P < 0.001) with MLC discrepancy, especially MLC velocity, which had an approximately linear relationship (slope = -0.0027, P < 0.001, R = 0.79). Incorporating MLC motion parameters, the final generalized model trained by data from all linear accelerators can predict MLC discrepancy to a high degree of accuracy with high correlation (R = 0.86) between predicted and actual MLC discrepancies. The same prediction results were found across different treatment sites and linear accelerators.
We have developed a machine learning model using trajectory log files to predict the MLC discrepancies during delivery. This model has been a released as a research tool in which a DICOM-RT with predicted MLC positions can be generated using the original DICOM-RT file as input. This tool can be used to simulate radiotherapy treatment delivery and may be useful for studies evaluating plan robustness and dosimetric uncertainties from treatment delivery.
多叶准直器(MLC)计划与实际(交付)位置之间的输送差异对调强放疗(IMRT)和容积旋转调强放疗(VMAT)的剂量分布准确性有不利影响。在这项研究中,我们评估了治疗过程中 MLC 输送差异的一致性,并随着时间的推移进行验证,以确保预测性机器学习模型在整个治疗过程中都是适用的。接下来,我们分析了先前轨迹日志文件中记录的 MLC 和龙门架位置,以构建一个机器学习算法,用于预测新治疗计划的 MLC 位置偏差。开发并发布了一个开源工具,用于预测任何给定计划在治疗时的 MLC 位置偏差。
收集并分析了来自 9 台瓦里安 TrueBeam 直线加速器的 142 个 IMRT 计划和 125 个 VMAT 计划的轨迹日志文件。评估了特定于患者的质量保证(QA)和患者治疗交付过程中输送差异的一致性。按治疗部位和机器类型对数据进行分组,以确定它们与 MLC 和龙门架角度偏差的关系。分析了与 MLC 和龙门架偏差相关的运动相关参数,包括 MLC 速度、MLC 加速度、控制点、剂量率和重力矢量、龙门架速度和龙门架加速度(如果适用)。使用了几种回归模型,如简单/多元线性回归、决策树和集成方法(提升树和袋装树模型),以开发一种基于 MLC 运动参数预测 MLC 偏差的机器学习算法。
特定于患者的 QA 中的 MLC 偏差与患者治疗输送中的 MLC 偏差不同,差异很小(IMRT 的平均值=0.0021±0.0036mm,P=0.0089;VMAT 的平均值=0.0010±0.0016mm,P=0.0003),但具有统计学意义,这可能是由于在 IMRT 中对 QA 设置了龙门架角度为零。MLC 运动参数,即 MLC 速度和重力矢量,与 MLC 偏差显示出显著的相关性(P<0.001),尤其是 MLC 速度,其具有近似线性关系(斜率=-0.0027,P<0.001,R=0.79)。将 MLC 运动参数纳入其中,由所有直线加速器的数据训练的最终广义模型可以以高相关性(R=0.86)准确地预测 MLC 偏差,并且预测的和实际的 MLC 偏差之间具有高度的相关性。在不同的治疗部位和直线加速器上都发现了相同的预测结果。
我们使用轨迹日志文件开发了一种机器学习模型,用于预测输送过程中的 MLC 偏差。该模型已作为研究工具发布,该工具可使用原始 DICOM-RT 文件作为输入,生成具有预测 MLC 位置的 DICOM-RT。该工具可用于模拟放射治疗输送,并且对于评估计划鲁棒性和治疗输送的剂量不确定性的研究可能很有用。