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      A deep learning based dynamic arc radiotherapy photon dose engine trained on Monte Carlo dose distributions

      research-article
      * ,
      Physics and Imaging in Radiation Oncology
      Elsevier
      Radiotherapy, Dose engine, Deep learning

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          Abstract

          Background and purpose

          Despite hardware acceleration, state-of-the-art Monte Carlo (MC) dose engines require considerable computation time to reduce stochastic noise. We developed a deep learning (DL) based dose engine reaching high accuracy at strongly reduced computation times.

          Materials and methods

          Radiotherapy treatment plans and computed tomography scans were collected for 350 treatments in a variety of tumor sites. Dose distributions were computed using a MC dose engine for 30,000 separate segments at 6 MV and 10 MV beam energies, both flattened and flattening filter free. For dynamic arcs these explicitly incorporated the leaf, jaw and gantry motions during dose delivery. A neural network was developed, combining two-dimensional convolution and recurrence using 64 hidden channels. Parameters were trained to minimize the mean squared log error loss between the MC computed dose and the model output. Full dose distributions were reconstructed for 100 additional treatment plans. Gamma analyses were performed to assess accuracy.

          Results

          DL dose evaluation was on average 82 times faster than MC computation at a 1 % accuracy setting. In voxels receiving at least 10 % of the maximum dose the overall global gamma pass rate using a 2 % and 2 mm criterion was 99.6 %, while mean local gamma values were accurate within 2 %. In the high dose region over 50 % of maximum the mean local gamma approached a 1 % accuracy.

          Conclusions

          A DL based dose engine was implemented, able to accurately reproduce MC computed dynamic arc radiotherapy dose distributions at high speed.

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          Most cited references19

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          Fast dose calculation in magnetic fields with GPUMCD.

          A new hybrid imaging-treatment modality, the MRI-Linac, involves the irradiation of the patient in the presence of a strong magnetic field. This field acts on the charged particles, responsible for depositing dose, through the Lorentz force. These conditions require a dose calculation engine capable of taking into consideration the effect of the magnetic field on the dose distribution during the planning stage. Also in the case of a change in anatomy at the time of treatment, a fast online replanning tool is desirable. It is improbable that analytical solutions such as pencil beam calculations can be efficiently adapted for dose calculations within a magnetic field. Monte Carlo simulations have therefore been used for the computations but the calculation speed is generally too slow to allow online replanning. In this work, GPUMCD, a fast graphics processing unit (GPU)-based Monte Carlo dose calculation platform, was benchmarked with a new feature that allows dose calculations within a magnetic field. As a proof of concept, this new feature is validated against experimental measurements. GPUMCD was found to accurately reproduce experimental dose distributions according to a 2%-2 mm gamma analysis in two cases with large magnetic field-induced dose effects: a depth-dose phantom with an air cavity and a lateral-dose phantom surrounded by air. Furthermore, execution times of less than 15 s were achieved for one beam in a prostate case phantom for a 2% statistical uncertainty while less than 20 s were required for a seven-beam plan. These results indicate that GPUMCD is an interesting candidate, being fast and accurate, for dose calculations for the hybrid MRI-Linac modality.
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            DeepDose: Towards a fast dose calculation engine for radiation therapy using deep learning.

            We present DeepDose, a deep learning framework for fast dose calculations in radiation therapy. Given a patient anatomy and linear-accelerator IMRT multi-leaf-collimator shape or segment, a novel set of physics-based inputs is calculated that encode the linac machine parameters into the underlying anatomy. These inputs are then used to train a deep convolutional network to derive the dose distribution of individual MLC shapes on a given patient anatomy. In this work we demonstrate the proof-of-concept application of DeepDose on 101 prostate patients treated in our clinic with fixed-beam IMRT. The ground-truth data used for training, validation and testing of the prediction were calculated with a state-of-the-art Monte Carlo dose engine at 1% statistical uncertainty per segment. A deep convolution network was trained using the data of 80 patients at the clinically used 3 mm3 grid spacing while 10 patients were used for validation. For another 11 independent test patients, the network was able to accurately estimate the segment doses from the clinical plans of each patient passing the clinical QA when compared with the Monte Carlo calculations, yielding on average 99.9%±0.3% for the forward calculated patient plans at 3%/3 mm gamma tests. Dose prediction using the trained network was very fast at approximately 0.9 seconds for the input generation and 0.6 seconds for single GPU inference per segment and 1 minute per patient in total. The overall performance of this dose calculation framework in terms of both accuracy and inference speed, makes it compelling for online adaptive workflows where fast segment dose calculations are needed.
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              Technical Note: A feasibility study on deep learning‐based radiotherapy dose calculation

              Various dose calculation algorithms are available for radiation therapy for cancer patients. However, these algorithms are faced with the tradeoff between efficiency and accuracy. The fast algorithms are generally less accurate, while the accurate dose engines are often time consuming. In this work, we try to resolve this dilemma by exploring deep learning (DL) for dose calculation. We developed a new radiotherapy dose calculation engine based on a modified Hierarchically Densely Connected U-net (HD U-net) model and tested its feasibility with prostate intensity-modulated radiation therapy (IMRT) cases. Mapping from an IMRT fluence map domain to a 3D dose domain requires a deep neural network of complicated architecture and a huge training dataset. To solve this problem, we first project the fluence maps to the dose domain using a broad beam ray-tracing algorithm, and then we use the HD U-net to map the ray-tracing dose distribution into an accurate dose distribution calculated using a collapsed cone convolution/superposition (CS) algorithm. The model is trained on 70 patients with 5-fold cross validation, and tested on a separate 8 patients. It takes about one second to compute a 3D dose distribution for a typical 7-field prostate IMRT plan, which can be further reduced to achieve real-time dose calculation by optimizing the network. The average Gamma passing rate between DL and CS dose distributions for the 8 test patients are 98.5% (±1.6%) at 1mm/1% and 99.9% (±0.1%) at 2mm/2%. For comparison of various clinical evaluation criteria (dose-volume points) for IMRT plans between two dose distributions, the average difference for dose criteria is less than 0.25 Gy while for volume criteria is less than 0.16%, showing that the DL dose distributions are clinically identical to the CS dose distributions. We have shown the feasibility of using DL for calculating radiotherapy dose distribution with high accuracy and efficiency.
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                Author and article information

                Contributors
                Journal
                Phys Imaging Radiat Oncol
                Phys Imaging Radiat Oncol
                Physics and Imaging in Radiation Oncology
                Elsevier
                2405-6316
                07 April 2024
                April 2024
                07 April 2024
                : 30
                : 100575
                Affiliations
                Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
                Author notes
                [* ]Corresponding author. m.witte@ 123456nki.nl
                Article
                S2405-6316(24)00045-9 100575
                10.1016/j.phro.2024.100575
                11031817
                38644934
                a204cd2e-b324-4c03-99e2-1b4a70f79b93
                © 2024 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 11 October 2023
                : 3 April 2024
                : 3 April 2024
                Categories
                Original Research Article

                radiotherapy,dose engine,deep learning
                radiotherapy, dose engine, deep learning

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