AI-based optimization for US-guided radiation therapy of the prostate

Int J Comput Assist Radiol Surg. 2022 Nov;17(11):2023-2032. doi: 10.1007/s11548-022-02664-6. Epub 2022 May 20.

Abstract

Objectives: Fast volumetric ultrasound presents an interesting modality for continuous and real-time intra-fractional target tracking in radiation therapy of lesions in the abdomen. However, the placement of the ultrasound probe close to the target structures leads to blocking some beam directions.

Methods: To handle the combinatorial complexity of searching for the ultrasound-robot pose and the subset of optimal treatment beams, we combine CNN-based candidate beam selection with simulated annealing for setup optimization of the ultrasound robot, and linear optimization for treatment plan optimization into an AI-based approach. For 50 prostate cases previously treated with the CyberKnife, we study setup and treatment plan optimization when including robotic ultrasound guidance.

Results: The CNN-based search substantially outperforms previous randomized heuristics, increasing coverage from 93.66 to 97.20% on average. Moreover, in some cases the total MU was also reduced, particularly for smaller target volumes. Results after AI-based optimization are similar for treatment plans with and without beam blocking due to ultrasound guidance.

Conclusions: AI-based optimization allows for fast and effective search for configurations for robotic ultrasound-guided radiation therapy. The negative impact of the ultrasound robot on the plan quality can successfully be mitigated resulting only in minor differences.

Keywords: Convolutional neural network; Heuristic optimization; Robotic ultrasound; Simulated annealing; Treatment planning.

MeSH terms

  • Humans
  • Male
  • Pelvis
  • Prostate* / diagnostic imaging
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Robotics* / methods
  • Ultrasonography / methods