A multi-centre evaluation of deep learning based radiotherapy planning for left-sided node-negative breast cancer

Physics and Imaging in Radiation Oncology, vol. 36, pp. 100839

Abstract

Background and Purpose Deep learning based planning (DLP) has the potential to improve consistency and efficiency in radiotherapy treatment planning. However, its clinical applicability remains limited, partly due to the need to translate a predicted dose into a deliverable dose. This study evaluated the generalisability of an institution specific DLP solution across multiple institutions by assessing its performance and developing a standardised translation parameter set. Materials and Methods Four institutions provided clinical treatment plans of 15 patients with left-sided node-negative breast cancer. Treatment plans delivering 40.05 Gy were generated using a deep learning prediction model trained on data from one institution. External validation was performed using national consensus criteria, by applying the initial parameter settings (InitialMimick) to datasets (n = 45) from three other institutions. A standardised parameter set (GenericMimick) was then developed based on data (n = 12) from all four institutions, whereafter it was evaluated on the remaining 48 patients of the dataset. Results InitialMimick plans showed higher average dose values in the planning target volume for the D mean (40.5 vs. 40.1 Gy) and D 2% (42.4 vs. 41.4 Gy), with fewer cases meeting all clinical goals (15/45) compared to clinical plans (25/45). After parameter adjustment, GenericMimick plans resulted in more plans meeting all goals (28/48), comparable to the clinical plans (30/48), with D mean of 40.3 vs. 40.1 Gy and D 2% of 41.9 vs. 41.5 Gy. Mean differences in organs at risk mean doses were less than 0.2 Gy. Conclusion DLP with a standardised translation parameter set demonstrated general applicability across multiple institutions.

Authors 13

1. Marlie Besouw corresponding

   Radboud University Nijmegen · Catharina Ziekenhuis · Radboud University Medical Center

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

   Radboudumc, Department of Medical Imaging, Nijmegen, the Netherlands

2. Niels van Acht

   Catharina Ziekenhuis · Eindhoven University of Technology

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

   Faculty of Electrical Engineering, Technical University Eindhoven, Eindhoven, the Netherlands

3. Dave van Gruijthuijsen

   Catharina Ziekenhuis

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

4. Thérèse van Nunen

   Catharina Ziekenhuis

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

5. Jorien van der Leer

   Catharina Ziekenhuis

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

6. Maurice van der Sangen

   Catharina Ziekenhuis

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

7. Jacqueline C.M. Theuws

   Catharina Ziekenhuis

   Affiliation as printed

   Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

8. Jean-Paul Kleijnen

   Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Haaglanden Medical Centre, Department of Radiation Oncology, The Hague, the Netherlands

9. A. Verbeek- de Kanter

   Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Haaglanden Medical Centre, Department of Radiation Oncology, The Hague, the Netherlands

10. Chrysi Papalazarou Aachen Department of Radiation Oncology

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands

11. Marcelle Immink Aachen Department of Radiation Oncology

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre, Department of Radiation Oncology, Leiden, the Netherlands

12. R.G.J. Kierkels

    Radiotherapiegroep

    Affiliation as printed

    Radiotherapiegroep, Institution for Radiation Oncology, Arnhem, the Netherlands

13. Coen Hurkmans

    Catharina Ziekenhuis · Eindhoven University of Technology

    Affiliation as printed

    Catharina Hospital, Department of Radiation Oncology, Eindhoven, the Netherlands

    Faculty of Applied Physics, Technical University Eindhoven, Eindhoven, the Netherlands

    Faculty of Electrical Engineering, Technical University Eindhoven, Eindhoven, the Netherlands