Automatic IMRT treatment planning through fluence prediction and plan fine-tuning for nasopharyngeal carcinoma.

BACKGROUND: At present, the implementation of intensity-modulated radiation therapy (IMRT) treatment planning for geometrically complex nasopharyngeal carcinoma (NPC) through manual trial-and-error fashion presents challenges to the improvement of planning efficiency and the obtaining of high-consistency plan quality. This paper aims to propose an automatic IMRT plan generation method through fluence prediction and further plan fine-tuning for patients with NPC and evaluates the planning efficiency and plan quality. METHODS: A total of 38 patients with NPC treated with nine-beam IMRT were enrolled in this study and automatically re-planned with the proposed method. A trained deep learning model was employed to generate static field fluence maps for each patient with 3D computed tomography images and structure contours as input. Automatic IMRT treatment planning was achieved by using its generated dose with slight tightening for further plan fine-tuning. Lastly, the plan quality was compared between automatic plans and clinical plans. RESULTS: The average time for automatic plan generation was less than 4 min, including fluence maps prediction with a python script and automated plan tuning with a C# script. Compared with clinical plans, automatic plans showed better conformity and homogeneity for planning target volumes (PTVs) except for the conformity of PTV-1. Meanwhile, the dosimetric metrics for most organs at risk (OARs) were ameliorated in the automatic plan, especially Dmax of the brainstem and spinal cord, and Dmean of the left and right parotid glands significantly decreased (P < 0.05). CONCLUSION: We have successfully implemented an automatic IMRT plan generation method for patients with NPC. This method shows high planning efficiency and comparable or superior plan quality than clinical plans. The qualitative results before and after the plan fine-tuning indicates that further optimization using dose objectives generated by predicted fluence maps is crucial to obtain high-quality automatic plans.

Simultaneous dose distribution and fluence prediction for nasopharyngeal carcinoma IMRT.

BACKGROUND: Current intensity-modulated radiation therapy (IMRT) treatment planning is still a manual and time/resource consuming task, knowledge-based planning methods with appropriate predictions have been shown to enhance the plan quality consistency and improve planning efficiency. This study aims to develop a novel prediction framework to simultaneously predict dose distribution and fluence for nasopharyngeal carcinoma treated with IMRT, the predicted dose information and fluence can be used as the dose objectives and initial solution for an automatic IMRT plan optimization scheme, respectively. METHODS: We proposed a shared encoder network to simultaneously generate dose distribution and fluence maps. The same inputs (three-dimensional contours and CT images) were used for both dose distribution and fluence prediction. The model was trained with datasets of 340 nasopharyngeal carcinoma patients (260 cases for training, 40 cases for validation, 40 cases for testing) treated with nine-beam IMRT. The predicted fluence was then imported back to treatment planning system to generate the final deliverable plan. Predicted fluence accuracy was quantitatively evaluated within projected planning target volumes in beams-eye-view with 5 mm margin. The comparison between predicted doses, predicted fluence generated doses and ground truth doses were also conducted inside patient body. RESULTS: The proposed network successfully predicted similar dose distribution and fluence maps compared with ground truth. The quantitative evaluation showed that the pixel-based mean absolute error between predicted fluence and ground truth fluence was 0.53% ± 0.13%. The structural similarity index also showed high fluence similarity with values of 0.96 ± 0.02. Meanwhile, the difference in the clinical dose indices for most structures between predicted dose, predicted fluence generated dose and ground truth dose were less than 1 Gy. As a comparison, the predicted dose achieved better target dose coverage and dose hot spot than predicted fluence generated dose compared with ground truth dose. CONCLUSION: We proposed an approach to predict 3D dose distribution and fluence maps simultaneously for nasopharyngeal carcinoma patients. Hence, the proposed method can be potentially integrated in a fast automatic plan generation scheme by using predicted dose as dose objectives and predicted fluence as a warm start.

Multimodality MRI synchronous construction based deep learning framework for MRI-guided radiotherapy synthetic CT generation.

Synthesizing computed tomography (CT) images from magnetic resonance imaging (MRI) data can provide the necessary electron density information for accurate dose calculation in the treatment planning of MRI-guided radiation therapy (MRIgRT). Inputting multimodality MRI data can provide sufficient information for accurate CT synthesis: however, obtaining the necessary number of MRI modalities is clinically expensive and time-consuming. In this study, we propose a multimodality MRI synchronous construction based deep learning framework from a single T1-weight (T1) image for MRIgRT synthetic CT (sCT) image generation. The network is mainly based on a generative adversarial network with sequential subtasks of intermediately generating synthetic MRIs and jointly generating the sCT image from the single T1 MRI. It contains a multitask generator and a multibranch discriminator, where the generator consists of a shared encoder and a splitted multibranch decoder. Specific attention modules are designed within the generator for feasible high-dimensional feature representation and fusion. Fifty patients with nasopharyngeal carcinoma who had undergone radiotherapy and had CT and sufficient MRI modalities scanned (5550 image slices for each modality) were used in the experiment. Results showed that our proposed network outperforms state-of-the-art sCT generation methods well with the least MAE, NRMSE, and comparable PSNR and SSIM index measure. Our proposed network exhibits comparable or even superior performance than the multimodality MRI-based generation method although it only takes a single T1 MRI image as input, thereby providing a more effective and economic solution for the laborious and high-cost generation of sCT images in clinical applications.

Incorporating the synthetic CT image for improving the performance of deformable image registration between planning CT and cone-beam CT.

Objective: To develop a contrast learning-based generative (CLG) model for the generation of high-quality synthetic computed tomography (sCT) from low-quality cone-beam CT (CBCT). The CLG model improves the performance of deformable image registration (DIR). Methods: This study included 100 post-breast-conserving patients with the pCT images, CBCT images, and the target contours, which the physicians delineated. The CT images were generated from CBCT images via the proposed CLG model. We used the Sct images as the fixed images instead of the CBCT images to achieve the multi-modality image registration accurately. The deformation vector field is applied to propagate the target contour from the pCT to CBCT to realize the automatic target segmentation on CBCT images. We calculate the Dice similarity coefficient (DSC), 95 % Hausdorff distance (HD95), and average surface distance (ASD) between the prediction and reference segmentation to evaluate the proposed method. Results: The DSC, HD95, and ASD of the target contours with the proposed method were 0.87 ± 0.04, 4.55 ± 2.18, and 1.41 ± 0.56, respectively. Compared with the traditional method without the synthetic CT assisted (0.86 ± 0.05, 5.17 ± 2.60, and 1.55 ± 0.72), the proposed method was outperformed, especially in the soft tissue target, such as the tumor bed region. Conclusion: The CLG model proposed in this study can create the high-quality sCT from low-quality CBCT and improve the performance of DIR between the CBCT and the pCT. The target segmentation accuracy is better than using the traditional DIR.

Impact of anti-dumping on global embodied air emissions: a complex network perspective.

After the rise of trade protectionism, anti-dumping has become a common means of political and trade games between countries. Global supply chains move production emissions between countries or regions through trade. In the context of carbon neutrality, anti-dumping measures representing the right to trade may become a tool for the game of emission rights between countries. Therefore, it is very important to study the environmental effects of anti-dumping to cope with global climate change and promote national development. Taking a sample of 189 countries and regions from the EORA input-output table with a study period of 2000-2016, we use the complex network, multi-regional input-output and panel regression models to verify the impact of anti-dumping on air emission transfer by constructing an anti-dumping network and an embodied air emission network. The results show that the initiator of anti-dumping can use anti-dumping to realize the cross-border transfer of ecological costs, reduce the burden of emission reduction and save more on emission quota. Developing countries lacking the right to speak in trade will increase the export volume of commodities after being subjected to a large number of anti-dumping sanctions, thus paying higher ecological costs and consuming more emission quotas. From a global perspective, additional emissions from product production can further contribute to global climate change.

An Unsupervised Learning-Based Regional Deformable Model for Automated Multi-Organ Contour Propagation.

The aim of this study is to evaluate a regional deformable model based on a deep unsupervised learning model for automatic contour propagation in breast cone-beam computed tomography-guided adaptive radiation therapy. A deep unsupervised learning model was introduced to map breast's tumor bed, clinical target volume, heart, left lung, right lung, and spinal cord from planning computed tomography to cone-beam CT. To improve the traditional image registration method's performance, we used a regional deformable framework based on the narrow-band mapping, which can mitigate the effect of the image artifacts on the cone-beam CT. We retrospectively selected 373 anonymized cone-beam CT volumes from 111 patients with breast cancer. The cone-beam CTs are divided into three sets. 311 / 20 / 42 cone-beam CT images were used for training, validating, and testing. The manual contour was used as reference for the testing set. We compared the results between the reference and the model prediction for evaluating the performance. The mean Dice between manual reference segmentations and the model predicted segmentations for breast tumor bed, clinical target volume, heart, left lung, right lung, and spinal cord were 0.78 ± 0.09, 0.90 ± 0.03, 0.88 ± 0.04, 0.94 ± 0.03, 0.95 ± 0.02, and 0.77 ± 0.07, respectively. The results demonstrated a good agreement between the reference and the proposed contours. The proposed deep learning-based regional deformable model technique can automatically propagate contours for breast cancer adaptive radiotherapy. Deep learning in contour propagation was promising, but further investigation was warranted.

Risk Transmission of Trade Price Fluctuations from a Nickel Chain Perspective: Based on Systematic Risk Entropy and Granger Causality Networks.

Nickel is a strategic mineral resource, with 65% of nickel being used in stainless steel. The situation in Ukraine starting in February 2022 has led to significant fluctuations in nickel prices, with prices of nickel products along the same chain affecting and passing through each other. Using systematic risk entropy and granger causality networks, we measure the volatility risk of trade prices of nickel products using the nickel industry chain trade data from 2000-2019 and explore the transmission patterns of different volatility risk prices from the industry chain perspective. The findings show that: (1) Nickel ore has the highest risk of import trade price volatility and a strong influence, but low risk transmission. Stainless steel has the highest trade price impact but is also subject to the strongest passive influence. (2) The Americas have a higher risk of trade price volatility but a weaker influence. The influence and sensitivity of trade prices is stronger in Asia and Europe. (3) Indonesia's stainless steel export prices have a high rate of transmission and strong influence. Germany's ferronickel export prices are highly susceptible to external influences and can continue to spread loudly. Russian nickel ore export prices are able to quickly spread their impact to other regions.

TransDose: a transformer-based UNet model for fast and accurate dose calculation for MR-LINACs.

Objective. To present a transformer-based UNet model (TransDose) for fast and accurate dose calculation for magnetic resonance-linear accelerators (MR-LINACs).Approach. A 2D fluence map from each beam was first projected into a 3D fluence volume and then fed into the TransDose model together with patient density volume and output predicted beam dose. The proposed TransDose model combined a 3D residual UNet with a transformer encoder, where convolutional layers extracted the volumetric spatial features, and the transformer encoder processed the long-range dependencies in a global space. Ninety-eight cases with four tumor sites (brain, nasopharynx, lung, and rectum) treated with fixed-beam intensity-modulated radiotherapy were included in the dataset; 78 cases were used for model training and validation; and 20 cases were used for testing. The ground-truth beam doses were calculated with Monte Carlo (MC) simulations within 1% statistical uncertainty and magnetic field strengthB = 1.5 T in the superior and inferior direction. Beam angles from the training and validation datasets were rotated 2-5 times, and doses were recalculated to augment the datasets.Results. The dose-volume histograms and indices between the predicted and MC doses showed good consistency. The average 3Dγ-passing rates (3%/2 mm, for dose regions above 10% of maximum dose) were 99.13 ± 0.89% (brain), 98.31 ± 1.92% (nasopharynx), 98.74 ± 0.70% (lung), and 99.28 ± 0.25% (rectum). The average dose calculation time, which included the fluence projection and model prediction, was less than 310 ms for each beam.Significance. We successfully developed a transformer-based UNet dose calculation model-TransDose in magnetic fields. Its accuracy and efficiency indicated its potential for use in online adaptive plan optimization for MR-LINACs.

A Deep Unsupervised Learning Model for Artifact Correction of Pelvis Cone-Beam CT.

PURPOSE: In recent years, cone-beam computed tomography (CBCT) is increasingly used in adaptive radiation therapy (ART). However, compared with planning computed tomography (PCT), CBCT image has much more noise and imaging artifacts. Therefore, it is necessary to improve the image quality and HU accuracy of CBCT. In this study, we developed an unsupervised deep learning network (CycleGAN) model to calibrate CBCT images for the pelvis to extend potential clinical applications in CBCT-guided ART. METHODS: To train CycleGAN to generate synthetic PCT (sPCT), we used CBCT and PCT images as inputs from 49 patients with unpaired data. Additional deformed PCT (dPCT) images attained as CBCT after deformable registration are utilized as the ground truth before evaluation. The trained uncorrected CBCT images are converted into sPCT images, and the obtained sPCT images have the characteristics of PCT images while keeping the anatomical structure of CBCT images unchanged. To demonstrate the effectiveness of the proposed CycleGAN, we use additional nine independent patients for testing. RESULTS: We compared the sPCT with dPCT images as the ground truth. The average mean absolute error (MAE) of the whole image on testing data decreased from 49.96 ± 7.21HU to 14.6 ± 2.39HU, the average MAE of fat and muscle ROIs decreased from 60.23 ± 7.3HU to 16.94 ± 7.5HU, and from 53.16 ± 9.1HU to 13.03 ± 2.63HU respectively. CONCLUSION: We developed an unsupervised learning method to generate high-quality corrected CBCT images (sPCT). Through further evaluation and clinical implementation, it can replace CBCT in ART.