Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy
Purpose: The machine learning–based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its performance. Methods and Materials: A total o...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-03-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109421000142 |
| _version_ | 1818420921209192448 |
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| author | Sua Yoo, PhD Yang Sheng, PhD Rachel Blitzblau, MD, PhD Susan McDuff, MD, PhD Colin Champ, MD Jay Morrison, BS, CMD Leigh O’Neill, BS, CMD Suzanne Catalano, BS, CMD Fang-Fang Yin, PhD Q. Jackie Wu, PhD |
| author_facet | Sua Yoo, PhD Yang Sheng, PhD Rachel Blitzblau, MD, PhD Susan McDuff, MD, PhD Colin Champ, MD Jay Morrison, BS, CMD Leigh O’Neill, BS, CMD Suzanne Catalano, BS, CMD Fang-Fang Yin, PhD Q. Jackie Wu, PhD |
| author_sort | Sua Yoo, PhD |
| collection | DOAJ |
| description | Purpose: The machine learning–based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its performance. Methods and Materials: A total of 102 patients of breast or chest wall treatment plans were prospectively evaluated with institutional review board approval. A human planner executed MLAP to create an auto-plan via automation of fluence maps generation. If judged necessary, a planner further fine-tuned the fluence maps to reach a final plan. Planners recorded the time required for auto-planning and manual modification. Target (ie, breast or chest wall and nodes) coverage and dose homogeneity were compared between the auto-plan and final plan. Results: Cases without nodes (n = 71) showed negligible (<1%) differences for target coverage and dose homogeneity between the auto-plan and final plan. Cases with nodes (n = 31) also showed negligible difference for target coverage. However, mean ± standard deviation of volume receiving 105% of the prescribed dose and maximum dose were reduced from 43.0% ± 26.3% to 39.4% ± 23.7% and 119.7% ± 9.5% to 114.4% ± 8.8% from auto-plan to final plan, respectively, all with P ≤ .01 for cases with nodes (n = 31). Mean ± standard deviation time spent for auto-plans and additional fluence modification for final plans were 12.1 ± 9.3 and 13.1 ± 12.9 minutes, respectively, for cases without nodes, and 16.4 ± 9.7 and 26.4 ± 16.4 minutes, respectively, for cases with nodes. Conclusions: The MLAP tool has been successfully implemented for routine clinical practice and has significantly improved planning efficiency. Clinical experience indicates that auto-plans are sufficient for target coverage, but improvement is warranted to reduce high dose volume for cases with nodal irradiation. This study demonstrates the clinical implementation of auto-planning for patient treatment and the significant importance of integrating human experience and feedback to improve MLAP for better clinical translation. |
| first_indexed | 2024-12-14T13:02:08Z |
| format | Article |
| id | doaj.art-3d18efba9fbd4677ba19aced858e711b |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-14T13:02:08Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-3d18efba9fbd4677ba19aced858e711b2022-12-21T23:00:25ZengElsevierAdvances in Radiation Oncology2452-10942021-03-0162100656Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation TherapySua Yoo, PhD0Yang Sheng, PhD1Rachel Blitzblau, MD, PhD2Susan McDuff, MD, PhD3Colin Champ, MD4Jay Morrison, BS, CMD5Leigh O’Neill, BS, CMD6Suzanne Catalano, BS, CMD7Fang-Fang Yin, PhD8Q. Jackie Wu, PhD9Corresponding author: Sua Yoo, PhD; Duke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaDuke University Medical Center, Durham, North CarolinaPurpose: The machine learning–based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its performance. Methods and Materials: A total of 102 patients of breast or chest wall treatment plans were prospectively evaluated with institutional review board approval. A human planner executed MLAP to create an auto-plan via automation of fluence maps generation. If judged necessary, a planner further fine-tuned the fluence maps to reach a final plan. Planners recorded the time required for auto-planning and manual modification. Target (ie, breast or chest wall and nodes) coverage and dose homogeneity were compared between the auto-plan and final plan. Results: Cases without nodes (n = 71) showed negligible (<1%) differences for target coverage and dose homogeneity between the auto-plan and final plan. Cases with nodes (n = 31) also showed negligible difference for target coverage. However, mean ± standard deviation of volume receiving 105% of the prescribed dose and maximum dose were reduced from 43.0% ± 26.3% to 39.4% ± 23.7% and 119.7% ± 9.5% to 114.4% ± 8.8% from auto-plan to final plan, respectively, all with P ≤ .01 for cases with nodes (n = 31). Mean ± standard deviation time spent for auto-plans and additional fluence modification for final plans were 12.1 ± 9.3 and 13.1 ± 12.9 minutes, respectively, for cases without nodes, and 16.4 ± 9.7 and 26.4 ± 16.4 minutes, respectively, for cases with nodes. Conclusions: The MLAP tool has been successfully implemented for routine clinical practice and has significantly improved planning efficiency. Clinical experience indicates that auto-plans are sufficient for target coverage, but improvement is warranted to reduce high dose volume for cases with nodal irradiation. This study demonstrates the clinical implementation of auto-planning for patient treatment and the significant importance of integrating human experience and feedback to improve MLAP for better clinical translation.http://www.sciencedirect.com/science/article/pii/S2452109421000142 |
| spellingShingle | Sua Yoo, PhD Yang Sheng, PhD Rachel Blitzblau, MD, PhD Susan McDuff, MD, PhD Colin Champ, MD Jay Morrison, BS, CMD Leigh O’Neill, BS, CMD Suzanne Catalano, BS, CMD Fang-Fang Yin, PhD Q. Jackie Wu, PhD Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy Advances in Radiation Oncology |
| title | Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy |
| title_full | Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy |
| title_fullStr | Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy |
| title_full_unstemmed | Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy |
| title_short | Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy |
| title_sort | clinical experience with machine learning based automated treatment planning for whole breast radiation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2452109421000142 |
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