Radiation Oncology Department, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China.
School of Automation Science and Electrical Engineering, Beihang University, Beijing, China.
Med Phys. 2024 Oct;51(10):7345-7355. doi: 10.1002/mp.17308. Epub 2024 Jul 18.
The current level of automation in the production of radiotherapy plans for lung cancer patients is relatively low. With the development of artificial intelligence, it has become a reality to use neural networks to predict dose distributions and provide assistance for radiation therapy planning. However, due to the significant individual variability in the distribution of non-small cell lung cancer (NSCLC) planning target volume (PTV) and the complex spatial relationships between the PTV and organs at risk (OARs), there is still a lack of a high-precision dose prediction network tailored to the characteristics of NSCLC.
To assist in the development of volumetric modulated arc therapy (VMAT) plans for non-small cell lung cancer patients, a deep neural network is proposed to predict high-precision dose distribution.
This study has developed a network called MHA-ResUNet, which combines a large-kernel dilated convolution module and multi-head attention (MHA) modules. The network was trained based on 80 VMAT plans of NSCLC patients. CT images, PTV, and OARs were fed into the independent input channel. The dose distribution was taken as the output to train the model. The performance of this network was compared with that of several commonly used networks, and the networks' performance was evaluated based on the voxel-level mean absolute error (MAE) within the PTV and OARs, as well as the error in clinical dose-volume metrics.
The MAE between the predicted dose distribution and the manually planned dose distribution within the PTV is 1.43 Gy, and the D95 error is less than 1 Gy. Compared with the other three commonly used networks, the dose error of the MHA-ResUNet is the smallest in PTV and OARs.
The proposed MHA-ResUNet network improves the receptive field and filters the shallow features to learn the relative spatial relation between the PTV and the OARs, enabling accurate prediction of dose distributions in NSCLC patients undergoing VMAT radiotherapy.
目前肺癌患者放射治疗计划的自动化水平相对较低。随着人工智能的发展,利用神经网络来预测剂量分布并为放射治疗计划提供辅助已经成为现实。然而,由于非小细胞肺癌(NSCLC)计划靶区(PTV)分布的个体差异较大,以及 PTV 与危及器官(OAR)之间的复杂空间关系,仍然缺乏针对 NSCLC 特征的高精度剂量预测网络。
为了辅助非小细胞肺癌患者容积调强弧形治疗(VMAT)计划的制定,提出了一种深度神经网络来预测高精度剂量分布。
本研究开发了一种名为 MHA-ResUNet 的网络,该网络结合了大核膨胀卷积模块和多头注意力(MHA)模块。该网络基于 80 例 NSCLC 患者的 VMAT 计划进行训练。将 CT 图像、PTV 和 OAR 分别输入独立的通道,以剂量分布作为输出来训练模型。比较了该网络与几种常用网络的性能,并基于 PTV 和 OAR 内的体素级平均绝对误差(MAE)以及临床剂量-体积指标的误差评估了网络的性能。
PTV 内预测剂量分布与手动计划剂量分布的 MAE 为 1.43 Gy,D95 误差小于 1 Gy。与其他三种常用网络相比,MHA-ResUNet 在 PTV 和 OAR 中的剂量误差最小。
所提出的 MHA-ResUNet 网络提高了感受野并过滤了浅层特征,以学习 PTV 与 OAR 之间的相对空间关系,从而能够准确预测接受 VMAT 放射治疗的 NSCLC 患者的剂量分布。