Domain Adaptation of Automated Treatment Planning from Computed Tomography to Magnetic Resonance
This work addresses the need for MR-only treatment planning workflows in radiation therapy, though it is incremental as it adapts an existing model rather than introducing a new method.
The study tackled the problem of adapting a machine learning-based radiation treatment planning model from CT to MR imaging for prostate cancer, finding that MR plans met 93.1% of evaluation criteria compared to 96.3% for CT plans, with significant dose differences in specific organs.
Objective: Machine learning (ML) based radiation treatment (RT) planning addresses the iterative and time-consuming nature of conventional inverse planning. Given the rising importance of Magnetic resonance (MR) only treatment planning workflows, we sought to determine if an ML based treatment planning model, trained on computed tomography (CT) imaging, could be applied to MR through domain adaptation. Methods: In this study, MR and CT imaging was collected from 55 prostate cancer patients treated on an MR linear accelerator. ML based plans were generated for each patient on both CT and MR imaging using a commercially available model in RayStation 8B. The dose distributions and acceptance rates of MR and CT based plans were compared using institutional dose-volume evaluation criteria. The dosimetric differences between MR and CT plans were further decomposed into setup, cohort, and imaging domain components. Results: MR plans were highly acceptable, meeting 93.1% of all evaluation criteria compared to 96.3% of CT plans, with dose equivalence for all evaluation criteria except for the bladder wall, penile bulb, small and large bowel, and one rectum wall criteria (p<0.05). Changing the input imaging modality (domain component) only accounted for about half of the dosimetric differences observed between MR and CT plans. Anatomical differences between the ML training set and the MR linac cohort (cohort component) were also a significant contributor. Significance: We were able to create highly acceptable MR based treatment plans using a CT-trained ML model for treatment planning, although clinically significant dose deviations from the CT based plans were observed.