Development of a deep learning-based error detection system without error dose maps in the patient-specific quality assurance of volumetric modulated arc therapy.

To detect errors in patient-specific quality assurance (QA) for volumetric modulated arc therapy (VMAT), we proposed an error detection method based on dose distribution analysis using unsupervised deep learning approach and analyzed 161 prostate VMAT beams measured with a cylindrical detector. For performing error simulation, in addition to error-free dose distribution, dose distributions containing nine types of error, including multileaf collimator (MLC) positional errors, gantry rotation errors, radiation output errors and phantom setup errors, were generated. Only error-free data were employed for the model training, and error-free and error data were employed for the tests. As a deep learning model, the variational autoencoder (VAE) was adopted. The anomaly of test data was quantified by calculating Mahalanobis distance based on the feature vectors acquired from a trained encoder. Based on this anomaly, test data were classified as 'error-free' or 'any-error.' For comparison with conventional approaches, gamma (γ)-analysis was performed, and supervised learning convolutional neural network (S-CNN) was constructed. Receiver operating characteristic curves were obtained to evaluate their performance with the area under the curve (AUC). For all error types, except systematic MLC positional and radiation output errors, the performance of the methods was in the order of S-CNN ˃ VAE-based ˃ γ-analysis (only S-CNN required error data for model training). For example, in random MLC positional error simulation, the AUC of our method, S-CNN and γ-analysis were 0.699, 0.921 and 0.669, respectively. Our results showed that the VAE-based method has the potential to detect errors in patient-specific VMAT QA.