Deep learning driven predictive treatment planning for adaptive radiotherapy of lung cancer Journal Article


Authors: Lee, D.; Hu, Y. C.; Kuo, L.; Alam, S.; Yorke, E.; Li, A.; Rimner, A.; Zhang, P.
Article Title: Deep learning driven predictive treatment planning for adaptive radiotherapy of lung cancer
Abstract: Background and purpose: To develop a novel deep learning algorithm of sequential analysis, Seq2Seq, for predicting weekly anatomical changes of lung tumor and esophagus during definitive radiotherapy, incorporate the potential tumor shrinkage into a predictive treatment planning paradigm, and improve the therapeutic ratio. Methods and materials: Seq2Seq starts with the primary tumor and esophagus observed on the planning CT to predict their geometric evolution during radiotherapy on a weekly basis, and subsequently updates the predictions with new snapshots acquired via weekly CBCTs. Seq2Seq is equipped with convolutional long short term memory to analyze the spatial–temporal changes of longitudinal images, trained and validated using a dataset including sixty patients. Predictive plans were optimized according to each weekly prediction and made ready for weekly deployment to mitigate the clinical burden of online weekly replanning. Results: Seq2Seq tracks structural changes well: DICE between predicted and actual weekly tumor and esophagus were (0.83 ± 0.10, 0.79 ± 0.14, 0.78 ± 0.12, 0.77 ± 0.12, 0.75 ± 0.12, 0.71 ± 0.17), and (0.72 ± 0.16, 0.73 ± 0.11, 0.75 ± 0.08, 0.74 ± 0.09, 0.72 ± 0.14, 0.71 ± 0.14), respectively, while the average Hausdorff distances were within 2 mm. Evaluating dose to the actual weekly tumor and esophagus, a 4.2 Gy reduction in esophagus mean dose while maintaining 60 Gy tumor coverage was achieved with the predictive weekly plans, compared to the plan optimized using the initial tumor and esophagus alone, primarily due to noticeable tumor shrinkage during radiotherapy. Conclusion: It is feasible to predict the longitudinal changes of tumor and esophagus with the Seq2Seq, which could lead to improving the efficiency and effectiveness of lung adaptive radiotherapy. © 2022 The Author(s)
Keywords: lung tumor; adaptive radiotherapy; deep learning; time series
Journal Title: Radiotherapy and Oncology
Volume: 169
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2022-04-01
Start Page: 57
End Page: 63
Language: English
DOI: 10.1016/j.radonc.2022.02.013
PUBMED: 35189155
PROVIDER: scopus
PMCID: PMC9018570
DOI/URL:
Notes: Article -- Export Date: 1 April 2022 -- Source: Scopus
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MSK Authors
  1. Li Cheng Kuo
    63 Kuo
  2. Andreas Rimner
    524 Rimner
  3. Pengpeng Zhang
    175 Zhang
  4. Ellen D Yorke
    450 Yorke
  5. Yu-Chi Hu
    118 Hu
  6. Donghoon Lee
    11 Lee
  7. Anyi Li
    18 Li