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Purpose: To develop a novel DVH scoring algorithm to predict and classify patient-specific quality assurance (PSQA) results by different DVH metrics automatically and efficiently.
Methods: A total of 200 cervical cancer patients who treated by Infinity (109 cases) and Synergy (91 cases) linear accelerators underwent volumetric modulated arc therapy (VMAT) from 2019 to 2022 were enrolled and used as technical testing (TT) and technical validation (TV) datasets, respectively, which was then randomly divided into training, validation and testing set at a ratio of 7:1:2. PSQA dose distributions were predicted using U-shape-like network with skip-connection modules (called T-Net) with the input of CT and plan dose distributions. A novel weight-based DVH scoring (WDS) algorithm was developed and trained to classify "pass" or "fail" (PoF) of PSQA results based on the dose errors (DEs) and volumetric errors (VEs) calculated between predicted and planned DVHs.
Results: T-Net achieved a best performance in predicting PSQA dose distributions in comparison with other deep learning models. The WDS method achieved a sensitivity, specificity and accuracy of 100.00 %, 50.00 %, 0.955, and 100.00 %,33.33 %, 0.890 in TT and TV, respectively, which was better than models of random forest (RF) and support vector machines (SVM) with an accuracy of 0.909, 0.833 and 0.864, 0.722 in TT and TV, respectively. The threshold DVH score for 22 and 18 validation patients were 49.62 and 57.62 in the TT and TV with a precision, recall rate and F1 score of 0.952, 1, 0.976 and 0.882, 1, 0.938, respectively.
Conclusions: The suggested novel WDS algorithm can improve the accuracy and efficiency of classifying the PoF of PSQA objectively and automatically.
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http://dx.doi.org/10.1016/j.apradiso.2025.112030 | DOI Listing |
ArXiv
August 2025
Department of Physics, The University of Texas at Arlington, Arlington, TX, United States.
Objective: This study aims to uncover the opaque decision-making process of an artificial intelligence (AI) agent for automatic treatment planning.
Approach: We examined a previously developed AI agent based on the Actor-Critic with Experience Replay (ACER) network, which automatically tunes treatment planning parameters (TPPs) for inverse planning in prostate cancer intensity modulated radiotherapy. We selected multiple checkpoint ACER agents from different stages of training and applied an explainable AI (EXAI) method to analyze the attribution from dose-volume histogram (DVH) inputs to TPP-tuning decisions.
Appl Radiat Isot
November 2025
School of Biomedical Engineering, Southern Medical University, China; Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, China; Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, China. Elec
Background And Purpose: In radiotherapy planning, achieving a balance between the dose distribution for the planning target volume (PTV) and organs-at-risk (OARs) is critical. This study introduces a joint learning mechanism to progressively refine predictions for PTVs and OARs, aiming to improve the accuracy of dose prediction for breast cancer.
Materials And Methods: The proposed model begins with constructing a dose prediction network tailored for the PTVs.
Med Phys
July 2025
School of Automation, Central South University, Changsha, China.
Background: Deep learning has been widely applied to the design of cancer radiotherapy treatment planning for dose distribution prediction. However, the significant variability in tumor size, quantity, and location poses substantial challenges for accurate dose distribution prediction in liver cancer radiotherapy.
Purpose: Given that the clinical effectiveness and accuracy of the predicted dose distribution directly impact the quality of treatment plans generated by automatic radiotherapy planning methods, this study aims to develop a novel and precise dose prediction method based on diffusion models.
Med Phys
July 2025
Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background: Conventional patient-specific quality assurance (PSQA) methods rely on time-consuming physical measurements. While previous studies have successfully employed machine learning (ML) models to predict gamma passing rates (GPRs), their clinical utility remains limited due to GPR's weak correlation with dose-volume histogram (DVH) parameters. Thus, developing a novel PSQA framework that is non-measured and DVH-based (NMDB) presents a promising alternative.
View Article and Find Full Text PDFAppl Radiat Isot
November 2025
Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China; School of Basic Medical Science, Wenzhou Medical University, Wenzhou, 325000, China. Electronic address:
Purpose: To develop a novel DVH scoring algorithm to predict and classify patient-specific quality assurance (PSQA) results by different DVH metrics automatically and efficiently.
Methods: A total of 200 cervical cancer patients who treated by Infinity (109 cases) and Synergy (91 cases) linear accelerators underwent volumetric modulated arc therapy (VMAT) from 2019 to 2022 were enrolled and used as technical testing (TT) and technical validation (TV) datasets, respectively, which was then randomly divided into training, validation and testing set at a ratio of 7:1:2. PSQA dose distributions were predicted using U-shape-like network with skip-connection modules (called T-Net) with the input of CT and plan dose distributions.