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. 2022 Jun;23(6):e13583.
doi: 10.1002/acm2.13583. Epub 2022 Mar 9.

The feasibility study on the generalization of deep learning dose prediction model for volumetric modulated arc therapy of cervical cancer

Zhang Qilin  1 , Bao Peng  2 , Qu Ang  1 , Jiang Weijuan  1 , Jiang Ping  1 , Zhuang Hongqing  1 , Dong Bin  3 , Yang Ruijie  1
Affiliations

The feasibility study on the generalization of deep learning dose prediction model for volumetric modulated arc therapy of cervical cancer

Zhang Qilin et al. J Appl Clin Med Phys. 2022 Jun.

Abstract

Purpose: To develop a 3D-Unet dose prediction model to predict the three-dimensional dose distribution of volumetric modulated arc therapy (VMAT) for cervical cancer and test the dose prediction performance of the model in endometrial cancer to explore the feasibility of model generalization.

Methods: One hundred and seventeen cases of cervical cancer and 20 cases of endometrial cancer treated with VMAT were used for the model training, validation, and test. The prescribed dose was 50.4 Gy in 28 fractions. Eight independent channels of contoured structures were input to the model, and the dose distribution was used as the output of the model. The 3D-Unet prediction model was trained and validated on the training set (n = 86) and validation set (n = 11), respectively. Then the model was tested on the test set (n = 20) of cervical cancer and endometrial cancer, respectively. The results between clinical dose distribution and predicted dose distribution were compared in the following aspects: (a) the mean absolute error (MAE) within the body, (b) the Dice similarity coefficients (DSCs) under different isodose volumes, (c) the dosimetric indexes including the mean dose (Dmean ), the received dose of 2 cm3 (D2cc) , the percentage volume of receiving 40 Gy dose of organs-at-risk (V40 ), planning target volume (PTV) D98% , and homogeneity index (HI), (d) dose-volume histograms (DVHs).

Results: The model can accurately predict the dose distribution of the VMAT plan for cervical cancer and endometrial cancer. The overall average MAE and maximum MAE for cervical cancer were 2.43 ± 3.17% and 3.16 ± 4.01% of the prescribed dose, respectively, and for endometrial cancer were 2.70 ± 3.54% and 3.85 ± 3.11%. The average DSCs under different isodose volumes is above 0.9. The predicted dosimetric indexes and DVHs are equivalent to the clinical dose for both cervical cancer and endometrial cancer, and there is no statistically significant difference.

Conclusion: A 3D-Unet dose prediction model was developed for VMAT of cervical cancer, which can predict the dose distribution accurately for cervical cancer. The model can also be generalized for endometrial cancer with good performance.

Keywords: cervical cancer; deep learning; dose prediction; generalization.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
3D‐Unet architecture, the number on each box represents the number of features extracted
FIGURE 2
FIGURE 2
The clinical dose distribution map, the model predicted dose distribution map, and the dose difference map at the same slice of the cervical cancer case. The left side is the clinical dose distribution map (the unit is Gy), the middle is the predicted dose distribution map and the right is the dose distribution difference map (take the prescription dose equal to 1 as the standard)
FIGURE 3
FIGURE 3
The clinical dose distribution map, the model predicted dose distribution map, and the dose difference map at the same slice of the endometrial cancer case. The left side is the clinical dose distribution map (the unit is Gy), the middle is the predicted dose distribution map, and the right is the dose distribution difference map (take the prescription dose equal to 1 as the standard)
FIGURE 4
FIGURE 4
Mean absolute errors of the 3D‐Unet model, including all voxels within the body for the 20 testing cases of cervical cancer and endometrial cancer, respectively
FIGURE 5
FIGURE 5
The Dice similarity coefficients (DSCs) of 20 testing cases of cervical cancer and endometrial cancer, respectively, under the isodose volume of 10%–100% (10% interval) of the prescribed dose
FIGURE 6
FIGURE 6
The representative dose–volume histograms (DVHs) of the tested cases. The upper picture shows the result of the cervical cancer case, and the lower picture shows the result of the endometrial cancer case
See this image and copyright information in PMC

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