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Centre-specific autonomous treatment plans for prostate brachytherapy using cGANs

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

In low-dose-rate prostate brachytherapy (LDR-PB), treatment planning is the process of determining the arrangement of implantable radioactive sources that radiates the prostate while sparing healthy surrounding tissues. Currently, these plans are prepared manually by experts incorporating the centre’s planning style and guidelines. In this article, we develop a novel framework that can learn a centre’s planning strategy and automatically reproduce rapid clinically acceptable plans.

Methods

The proposed framework is based on conditional generative adversarial networks that learn our centre’s planning style using a pool of 931 historical LDR-PB planning data. Two additional losses that help constrain prohibited needle patterns and produce similar-looking plans are also proposed. Once trained, this model generates an initial distribution of needles which is passed to a planner. The planner then initializes the sources based on the predicted needles and uses a simulated annealing algorithm to optimize their locations further.

Results

Quantitative analysis was carried out on 170 cases which showed the generated plans having similar dosimetry to that of the manual plans but with significantly lower planning durations. Indeed, on the test cases, the clinical target volumes achieving \(100\%\) of the prescribed dose for the generated plans was on average \(98.98\%\) (\(99.36\%\) for manual plans) with an average planning time of \(3.04\pm 1.1\) min (\(20\pm 10\) min for manual plans). Further qualitative analysis was conducted by an expert planner who accepted \(90\%\) of the plans with some changes (\(60\%\) requiring minor changes & \(30\%\) requiring major changes).

Conclusion

The proposed framework demonstrated the ability to rapidly generate quality treatment plans that not only fulfil the dosimetric requirements but also takes into account the centre’s planning style. Adoption of such a framework would save significant amount of time and resources spent on every patient; boosting the overall operational efficiency of this treatment.

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Funding

This work was supported by the Canadian Institutes of Health Research (CIHR) (Grant Nos. CIHR MOP-1422439, CIHR PJT 152965).

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Authors and Affiliations

  1. School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada

    Tajwar Abrar Aleef

  2. Department of Medical Physics, BC Cancer - Vancouver Centre, Vancouver, BC, Canada

    Ingrid T. Spadinger & S. Sara Mahdavi

  3. Department of Radiation Oncology, BC Cancer - Vancouver Centre, Vancouver, BC, Canada

    Michael D. Peacock

  4. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada

    Septimiu E. Salcudean

Authors
  1. Tajwar Abrar Aleef
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  2. Ingrid T. Spadinger
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  3. Michael D. Peacock
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  4. Septimiu E. Salcudean
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  5. S. Sara Mahdavi
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Corresponding author

Correspondence to Tajwar Abrar Aleef.

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Conflict of interest

The authors declare that they have no conflict of interest.

Availability of data and material

Not applicable.

Code availability

Implementation of our 3D cGANs technique is available in the following link: https://github.com/tajwarabraraleef/3Dpix2pix-for-prostate-brachytherapy.

Ethics approval

Institutional ethics approval was obtained for the use of clinical data in this study.

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Aleef, T.A., Spadinger, I.T., Peacock, M.D. et al. Centre-specific autonomous treatment plans for prostate brachytherapy using cGANs. Int J CARS 16, 1161–1170 (2021). https://doi.org/10.1007/s11548-021-02405-1

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  • DOI: https://doi.org/10.1007/s11548-021-02405-1

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