Towards artificial intelligence-based automated treatment planning in clinical practice: A prospective study of the first clinical experiences in high-dose-rate prostate brachytherapy

Barten, D.; Pieters, Bradley R.; Bouter, Anton; Meer, Marjolein C. van der; Maree, Stef C.; Hinnen, Karel A.; Westerveld, Henrike; Bosman, Peter A. N.; Alderliesten, Tanja; Wieringen, N. Van; Bel, Arjan

doi:10.1016/j.brachy.2022.11.013

Cited by 2 publications

(2 citation statements)

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“…22 Recent studies using multi-criteria optimization (MCO) in HDR brachytherapy suggest that the plan quality (with and without catheter optimization) superseded the one of the clinical plans (CP) generated with standard optimization methods (HDR prostate studies). [23][24][25][26] One recent study in MCO was conducted for IC/IS GYN implants and favored MCO plans over CP, but did not consider catheter optimization. 27 With the need to offer efficient optimization tools for HDR GYN brachytherapy with complex IC/IS applicators, the purpose of this work is to develop a fast optimization algorithm that combines catheter optimization (position, number and depth) and MCO for the Venezia applicator.…”

Section: Introductionmentioning

confidence: 99%

“…One recent study investigated a pre‐plan method to determine the number, position and depth of IS catheters for the Venezia applicator, but no mathematical optimization method is used or described 22 . Recent studies using multi‐criteria optimization (MCO) in HDR brachytherapy suggest that the plan quality (with and without catheter optimization) superseded the one of the clinical plans (CP) generated with standard optimization methods (HDR prostate studies) 23–26 . One recent study in MCO was conducted for IC/IS GYN implants and favored MCO plans over CP, but did not consider catheter optimization 27 …”

Section: Introductionmentioning

confidence: 99%

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Simultaneous catheter and multicriteria optimization for HDR cervical cancer brachytherapy with a complex intracavity/interstitial applicator

Bélanger,

Aubin,

Lavallée

et al. 2023

Medical Physics

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BackgroundComplex intracavity and interstitial (IC/IS) applicators, such as the Venezia applicator, can improve the HR‐CTV coverage while adequately protecting organs at risk in the treatment of cervical cancer with high‐dose‐rate (HDR) brachytherapy. Although the Venezia applicator offers more choice for catheter selection, commercially available catheter and dose optimization algorithms are still missing for complex applicators. Moreover, studies on catheter and dose optimization for IC/IS implants in the treatment of cervical cancer are still limited.PurposeThis work aims to combine a GPU‐based multi‐criteria optimization (gMCO) algorithm with a sparse catheter (SC) optimization algorithm for the Venezia applicator.MethodsFifty‐eight cervical cancer patients who received 28 Gy in 4 fx of HDR brachytherapy with the Venezia applicator (combination to external beam radiation therapy) are retrospectively revisited. The modelization of the applicator is done by virtually reconstructing all the IS catheters passing through the ring. Template catheters are reconstructed using an in‐house python script. To perform simultaneous MCO and SC optimization (SC+MCO), the objective function includes aggregated dose objectives in a weighted sum and a group sparsity term that individually penalizes the contribution of IS catheters. Plans generated with the SC+MCO algorithm are compared with plans generated with MCO using clinical catheters (CC+MCO) and the clinical plans (CP). The EMBRACE II soft constraints (planning aims) and hard constraints (limits for prescribed dose) are used as plan evaluation criteria.ResultsCC+MCO gives the most important gain with an increase up to 20.7% in meeting all EMBRACE II soft constraints compared with CP. The SC+MCO algorithm (adding catheter optimization to MCO) provides a second order increase (up to 12.1% with total acceptance rate of 60.3% or 35/58) in the acceptance rate versus CC+MCO (total increase of 32.8% vs. CP). Acceptance rate in EMBRACE II hard constraints is 98.3% (57/58) for both CC+MCO and SC+MCO versus 91.4% (53/58) for CP. The median SC+MCO optimization time is 11 s to generate a total of 5000 Pareto‐optimal plans with different catheter configurations (position and number) for each fraction.ConclusionsSimultaneous catheter and MCO optimization is clinically feasible for HDR cervical cancer brachytherapy using the Venezia applicator. Clinical catheter configurations could be improved and/or the catheter number could be reduced without decreasing plan quality using SC+MCO compared with the CP.

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