Automatic Planning of Whole Breast Radiation Therapy Using Machine Learning Models.

Sheng, Yang

Li, Taoran

Yoo, Sua

Yin, Fang-Fang

Blitzblau, Rachel

Horton, Janet K

Ge, Yaorong

Wu, Q Jackie

2019-10-01T13:34:58Z

2019-10-01T13:34:58Z

2019-01

2019-10-01T13:34:56Z

Purpose: To develop an automatic treatment planning system for whole breast radiation therapy (WBRT) based on two intensity-modulated tangential fields, enabling near-real-time planning. Methods and Materials: A total of 40 WBRT plans from a single institution were included in this study under IRB approval. Twenty WBRT plans, 10 with single energy (SE, 6MV) and 10 with mixed energy (ME, 6/15MV), were randomly selected as training dataset to develop the methodology for automatic planning. The rest 10 SE cases and 10 ME cases served as validation. The auto-planning process consists of three steps. First, an energy prediction model was developed to automate energy selection. This model establishes an anatomy-energy relationship based on principle component analysis (PCA) of the gray level histograms from training cases' digitally reconstructed radiographs (DRRs). Second, a random forest (RF) model generates an initial fluence map using the selected energies. Third, the balance of overall dose contribution throughout the breast tissue is realized by automatically selecting anchor points and applying centrality correction. The proposed method was tested on the validation dataset. Non-parametric equivalence test was performed for plan quality metrics using one-sided Wilcoxon Signed-Rank test. Results: For validation, the auto-planning system suggested same energy choices as clinical-plans in 19 out of 20 cases. The mean (standard deviation, SD) of percent target volume covered by 100% prescription dose was 82.5% (4.2%) for auto-plans, and 79.3% (4.8%) for clinical-plans (p > 0.999). Mean (SD) volume receiving 105% Rx were 95.2 cc (90.7 cc) for auto-plans and 83.9 cc (87.2 cc) for clinical-plans (p = 0.108). Optimization time for auto-plan was <20 s while clinical manual planning takes between 30 min and 4 h. Conclusions: We developed an automatic treatment planning system that generates WBRT plans with optimal energy selection, clinically comparable plan quality, and significant reduction in planning time, allowing for near-real-time planning.

2234-943X

2234-943X

https://hdl.handle.net/10161/19356

eng

Frontiers Media SA

Frontiers in Oncology

10.3389/fonc.2019.00750

auto planning

breast cancer

electronic compensation

machine learning

random forest

whole breast radiation therapy

Automatic Planning of Whole Breast Radiation Therapy Using Machine Learning Models.

Journal article

Sheng, Yang|0000-0003-3380-1966

Yin, Fang-Fang|0000-0002-2025-4740|0000-0003-1064-2149

Blitzblau, Rachel|0000-0002-4296-2238

750

AUG

School of Medicine

Duke

Radiation Oncology

Clinical Science Departments

Duke Kunshan University Faculty

Duke Kunshan University

Duke Cancer Institute

Institutes and Centers

Published

9