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Register a new userPost-Radiotherapy PET Image Outcome Prediction by Deep Learning under Biological Model Guidance: A Feasibility Study of Oropharyngeal Cancer Application
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This paper develops a method of biologically guided deep learning for post-radiation FDG-PET image outcome prediction based on pre-radiation images and radiotherapy dose information. Based on the classic reaction-diffusion mechanism, a novel biological model was proposed using a partial differential equation that incorporates spatial radiation dose distribution as a patient-specific treatment information variable. A 7-layer encoder-decoder-based convolutional neural network (CNN) was designed and trained to learn the proposed biological model. As such, the model could generate post-radiation FDG-PET image outcome predictions with possible time-series transition from pre-radiotherapy image states to post-radiotherapy states. The proposed method was developed using 64 oropharyngeal patients with paired FDG-PET studies before and after 20Gy delivery (2Gy/daily fraction) by IMRT. In a two-branch deep learning execution, the proposed CNN learns specific terms in the biological model from paired FDG-PET images and spatial dose distribution as in one branch, and the biological model generates post-20Gy FDG-PET image prediction in the other branch. The proposed method successfully generated post-20Gy FDG-PET image outcome prediction with breakdown illustrations of biological model components. Time-series FDG-PET image predictions were generated to demonstrate the feasibility of disease response rendering. The developed biologically guided deep learning method achieved post-20Gy FDG-PET image outcome predictions in good agreement with ground-truth results. With break-down biological modeling components, the outcome image predictions could be used in adaptive radiotherapy decision-making to optimize personalized plans for the best outcome in the future.
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We investigated the ability of deep learning models for imaging based HPV status detection. To overcome the problem of small medical datasets we used a transfer learning approach. A 3D convolutional network pre-trained on sports video clips was fine tuned such that full 3D information in the CT images could be exploited. The video pre-trained model was able to differentiate HPV-positive from HPV-negative cases with an area under the receiver operating characteristic curve (AUC) of 0.81 for an external test set. In comparison to a 3D convolutional neural network (CNN) trained from scratch and a 2D architecture pre-trained on ImageNet the video pre-trained model performed best.
Purpose: Radiation therapy treatment planning is a trial-and-error, often time-consuming process. An optimal dose distribution based on a specific anatomy can be predicted by pre-trained deep learning (DL) models. However, dose distributions are often optimized based on not only patient-specific anatomy but also physician preferred trade-offs between planning target volume (PTV) coverage and organ at risk (OAR) sparing. Therefore, it is desirable to allow physicians to fine-tune the dose distribution predicted based on patient anatomy. In this work, we developed a DL model to predict the individualized 3D dose distributions by using not only the anatomy but also the desired PTV/OAR trade-offs, as represented by a dose volume histogram (DVH), as inputs. Methods: The desired DVH, fine-tuned by physicians from the initially predicted DVH, is first projected onto the Pareto surface, then converted into a vector, and then concatenated with mask feature maps. The network output for training is the dose distribution corresponding to the Pareto optimal DVH. The training/validation datasets contain 77 prostate cancer patients, and the testing dataset has 20 patients. Results: The trained model can predict a 3D dose distribution that is approximately Pareto optimal. We calculated the difference between the predicted and the optimized dose distribution for the PTV and all OARs as a quantitative evaluation. The largest average error in mean dose was about 1.6% of the prescription dose, and the largest average error in the maximum dose was about 1.8%. Conclusions: In this feasibility study, we have developed a 3D U-Net model with the anatomy and desired DVH as inputs to predict an individualized 3D dose distribution. The predicted dose distributions can be used as references for dosimetrists and physicians to rapidly develop a clinically acceptable treatment plan.
Deep learning (DL) methods have in recent years yielded impressive results in medical imaging, with the potential to function as clinical aid to radiologists. However, DL models in medical imaging are often trained on public research cohorts with images acquired with a single scanner or with strict protocol harmonization, which is not representative of a clinical setting. The aim of this study was to investigate how well a DL model performs in unseen clinical data sets---collected with different scanners, protocols and disease populations---and whether more heterogeneous training data improves generalization. In total, 3117 MRI scans of brains from multiple dementia research cohorts and memory clinics, that had been visually rated by a neuroradiologist according to Scheltens scale of medial temporal atrophy (MTA), were included in this study. By training multip
Adaptive radiotherapy (ART), especially online ART, effectively accounts for positioning errors and anatomical changes. One key component of online ART is accurately and efficiently delineating organs at risk (OARs) and targets on online images, such as CBCT, to meet the online demands of plan evaluation and adaptation. Deep learning (DL)-based automatic segmentation has gained great success in segmenting planning CT, but its applications to CBCT yielded inferior results due to the low image quality and limited available contour labels for training. To overcome these obstacles to online CBCT segmentation, we propose a registration-guided DL (RgDL) segmentation framework that integrates image registration algorithms and DL segmentation models. The registration algorithm generates initial contours, which were used as guidance by DL model to obtain accurate final segmentations. We had two implementations the proposed framework--Rig-RgDL (Rig for rigid body) and Def-RgDL (Def for deformable)--with rigid body (RB) registration or deformable image registration (DIR) as the registration algorithm respectively and U-Net as DL model architecture. The two implementations of RgDL framework were trained and evaluated on seven OARs in an institutional clinical Head and Neck (HN) dataset. Compared to the baseline approaches using the registration or the DL alone, RgDL achieved more accurate segmentation, as measured by higher mean Dice similarity coefficients (DSC) and other distance-based metrics. Rig-RgDL achieved a DSC of 84.5% on seven OARs on average, higher than RB or DL alone by 4.5% and 4.7%. The DSC of Def-RgDL is 86.5%, higher than DIR or DL alone by 2.4% and 6.7%. The inference time took by the DL model to generate final segmentations of seven OARs is less than one second in RgDL. The resulting segmentation accuracy and efficiency show the promise of applying RgDL framework for online ART.
In medical imaging, radiological scans of different modalities serve to enhance different sets of features for clinical diagnosis and treatment planning. This variety enriches the source information that could be used for outcome prediction. Deep learning methods are particularly well-suited for feature extraction from high-dimensional inputs such as images. In this work, we apply a CNN classification network augmented with a FCN preprocessor sub-network to a public TCIA head and neck cancer dataset. The training goal is survival prediction of radiotherapy cases based on pre-treatment FDG PET-CT scans, acquired across 4 different hospitals. We show that the preprocessor sub-network in conjunction with aggregated residual connection leads to improvements over state-of-the-art results when combining both CT and PET input images.
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