Unsupervised Domain Adaptive Dose Prediction via Cross-Attention Transformer and Target-Specific Knowledge Preservation.

Radiotherapy is one of the leading treatments for cancer. To accelerate the implementation of radiotherapy in clinic, various deep learning-based methods have been developed for automatic dose prediction. However, the effectiveness of these methods heavily relies on the availability of a substantial amount of data with labels, i.e. the dose distribution maps, which cost dosimetrists considerable time and effort to acquire. For cancers of low-incidence, such as cervical cancer, it is often a luxury to collect an adequate amount of labeled data to train a well-performing deep learning (DL) model. To mitigate this problem, in this paper, we resort to the unsupervised domain adaptation (UDA) strategy to achieve accurate dose prediction for cervical cancer (target domain) by leveraging the well-labeled high-incidence rectal cancer (source domain). Specifically, we introduce the cross-attention mechanism to learn the domain-invariant features and develop a cross-attention transformer-based encoder to align the two different cancer domains. Meanwhile, to preserve the target-specific knowledge, we employ multiple domain classifiers to enforce the network to extract more discriminative target features. In addition, we employ two independent convolutional neural network (CNN) decoders to compensate for the lack of spatial inductive bias in the pure transformer and generate accurate dose maps for both domains. Furthermore, to enhance the performance, two additional losses, i.e. a knowledge distillation loss (KDL) and a domain classification loss (DCL), are incorporated to transfer the domain-invariant features while preserving domain-specific information. Experimental results on a rectal cancer dataset and a cervical cancer dataset have demonstrated that our method achieves the best quantitative results with [Formula: see text], [Formula: see text], and HI of 1.446, 1.231, and 0.082, respectively, and outperforms other methods in terms of qualitative assessment.