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Towards artificial intelligence-based automated treatment planning in clinical practice: A prospective study of the first clinical experiences in high-dose-rate prostate brachytherapy

  • Danique L.J. Barten
    Correspondence
    Corresponding author: Danique L.J. Barten, Amsterdam UMC, location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel.: +31-20-7327826.
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Bradley R. Pieters
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Anton Bouter
    Affiliations
    Centrum Wiskunde & Informatica (CWI), Life Sciences and Health, Amsterdam, The Netherlands
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  • Marjolein C. van der Meer
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Stef C. Maree
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Karel A. Hinnen
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Henrike Westerveld
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Peter A.N. Bosman
    Affiliations
    Centrum Wiskunde & Informatica (CWI), Life Sciences and Health, Amsterdam, The Netherlands
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  • Tanja Alderliesten
    Affiliations
    Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
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  • Niek van Wieringen
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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  • Arjan Bel
    Affiliations
    Department of Radiation Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

    Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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Published:January 10, 2023DOI:https://doi.org/10.1016/j.brachy.2022.11.013

      ABSTRACT

      Purpose

      This prospective study evaluates our first clinical experiences with the novel ``BRachytherapy via artificial Intelligent GOMEA-Heuristic based Treatment planning'' (BRIGHT) applied to high-dose-rate prostate brachytherapy.

      MethodS AND MATERIALs

      Between March 2020 and October 2021, 14 prostate cancer patients were treated in our center with a 15Gy HDR-brachytherapy boost. BRIGHT was used for bi-objective treatment plan optimization and selection of the most desirable plans from a coverage-sparing trade-off curve. Selected BRIGHT plans were imported into the commercial treatment planning system Oncentra Brachy . In Oncentra Brachy a dose distribution comparison was performed for clinical plan choice, followed by manual fine-tuning of the preferred BRIGHT plan when deemed necessary.
      The reasons for plan selection, clinical plan choice, and fine-tuning, as well as process speed were monitored. For each patient, the dose-volume parameters of the (fine-tuned) clinical plan were evaluated.

      Results

      In all patients, BRIGHT provided solutions satisfying all protocol values for coverage and sparing. In four patients not all dose-volume criteria of the clinical plan were satisfied after manual fine-tuning. Detailed information on tumour coverage, dose-distribution, dwell time pattern, and insight provided by the patient-specific trade-off curve, were used for clinical plan choice. Median time spent on treatment planning was 42 min, consisting of 16 min plan optimization and selection, and 26 min undesirable process steps.

      ConclusionS

      BRIGHT is implemented in our clinic and provides automated prostate high-dose-rate brachytherapy planning with trade-off based plan selection. Based on our experience, additional optimization aims need to be implemented to further improve direct clinical applicability of treatment plans and process efficiency.

      Keywords

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