Antony Lomax

Muheng Li, Xia Li, Sairos Safai et al.

In recent advancements in proton therapy, MR-based treatment planning is gaining momentum to minimize additional radiation exposure compared to traditional CT-based methods. This transition highlights the critical need for accurate MR-to-CT image synthesis, which is essential for precise proton dose calculations. Our research introduces the Diffusion Schrödinger Bridge Models (DSBM), an innovative approach for high-quality MR-to-CT synthesis. DSBM learns the nonlinear diffusion processes between MR and CT data distributions. This method improves upon traditional diffusion models by initiating synthesis from the prior distribution rather than the Gaussian distribution, enhancing both generation quality and efficiency. We validated the effectiveness of DSBM on a head and neck cancer dataset, demonstrating its superiority over traditional image synthesis methods through both image-level and dosimetric-level evaluations. The effectiveness of DSBM in MR-based proton treatment planning highlights its potential as a valuable tool in various clinical scenarios.

Xia Li, Runzhao Yang, Xiangtai Li et al.

Motion information from 4D medical imaging offers critical insights into dynamic changes in patient anatomy for clinical assessments and radiotherapy planning and, thereby, enhances the capabilities of 3D image analysis. However, inherent physical and technical constraints of imaging hardware often necessitate a compromise between temporal resolution and image quality. Frame interpolation emerges as a pivotal solution to this challenge. Previous methods often suffer from discretion when they estimate the intermediate motion and execute the forward warping. In this study, we draw inspiration from fluid mechanics to propose a novel approach for continuously modeling patient anatomic motion using implicit neural representation. It ensures both spatial and temporal continuity, effectively bridging Eulerian and Lagrangian specifications together to naturally facilitate continuous frame interpolation. Our experiments across multiple datasets underscore the method's superior accuracy and speed. Furthermore, as a case-specific optimization (training-free) approach, it circumvents the need for extensive datasets and addresses model generalization issues.

Muheng Li, Evangelia Choulilitsa, Lisa Fankhauser et al.

Accurate dose calculation on cone beam computed tomography (CBCT) images is essential for modern proton treatment planning workflows, particularly when accounting for inter-fractional anatomical changes in adaptive treatment scenarios. Traditional CBCT-based dose calculation suffers from image quality limitations, requiring complex correction workflows. This study develops and validates a deep learning approach for direct proton dose calculation from CBCT images using extended Long Short-Term Memory (xLSTM) neural networks. A retrospective dataset of 40 head-and-neck cancer patients with paired planning CT and treatment CBCT images was used to train an xLSTM-based neural network (CBCT-NN). The architecture incorporates energy token encoding and beam's-eye-view sequence modelling to capture spatial dependencies in proton dose deposition patterns. Training utilized 82,500 paired beam configurations with Monte Carlo-generated ground truth doses. Validation was performed on 5 independent patients using gamma analysis, mean percentage dose error assessment, and dose-volume histogram comparison. The CBCT-NN achieved gamma pass rates of 95.1 $\pm$ 2.7% using 2mm/2% criteria. Mean percentage dose errors were 2.6 $\pm$ 1.4% in high-dose regions ($>$90% of max dose) and 5.9 $\pm$ 1.9% globally. Dose-volume histogram analysis showed excellent preservation of target coverage metrics (Clinical Target Volume V95% difference: -0.6 $\pm$ 1.1%) and organ-at-risk constraints (parotid mean dose difference: -0.5 $\pm$ 1.5%). Computation time is under 3 minutes without sacrificing Monte Carlo-level accuracy. This study demonstrates the proof-of-principle of direct CBCT-based proton dose calculation using xLSTM neural networks. The approach eliminates traditional correction workflows while achieving comparable accuracy and computational efficiency suitable for adaptive protocols.

Xia Li, Fabian Zhang, Muheng Li et al.

Intra-fraction motion in radiotherapy is commonly modeled using deformable image registration (DIR). However, existing methods often struggle to balance speed and accuracy, limiting their applicability in clinical scenarios. This study introduces a novel approach that harnesses Neural Graphics Primitives (NGP) to optimize the displacement vector field (DVF). Our method leverages learned primitives, processed as splats, and interpolates within space using a shallow neural network. Uniquely, it enables self-supervised optimization at an ultra-fast speed, negating the need for pre-training on extensive datasets and allowing seamless adaptation to new cases. We validated this approach on the 4D-CT lung dataset DIR-lab, achieving a target registration error (TRE) of 1.15\pm1.15 mm within a remarkable time of 1.77 seconds. Notably, our method also addresses the sliding boundary problem, a common challenge in conventional DIR methods.