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An Automated Treatment Planning Module in AutoBrachy for Interstitial High-Dose-Rate Brachytherapy of Gynecological Cancer

Y Gonzalez1,2,3*, C Shen1,2,3 , H Jung1,2,3 , K Albuquerque3 , X Jia1,2,3 , (1) innovative Technology Of Radiotherapy Computations and Hardware (iTORCH) Laboratory, (2) Medical Artificial Intelligence and Automation (MAIA) Laboratory, (3) University of Texas Southwestern Medical Center, Dallas, TX


(Thursday, 7/18/2019) 7:30 AM - 9:30 AM

Room: 301

Purpose: To automate the planning process of high-dose-rate brachytherapy (HDRBT) of gynecological cancer to improve efficiency and ensure plan quality, we have developed and implemented the AutoBrachy system at our institution. Treatment planning for HDRBT with interstitial needle applicators is particularly complex, time-consuming, and prone to human error. We have developed a new auto-planning module in AutoBrachy for HDRBT with interstitial needle applicators.

Methods: The auto-planning module works in the following steps. 1) Patient CT images are sent to a central server where they are imported to the treatment planning system (TPS). A physician contours the CTV. Organs of interest (OARs) including bladder, rectum, sigmoid are contoured either manually or by a deep-learning based segmentation module followed by a human inspection and correction. The CT and DICOM-RS file containing the contours are exported to the central server where they are accessed by the auto-planning module. 2) The auto-planning module digitizes all the needles and tandem using a deep-learning assisted needle digitization tool. Dwell positions are placed in all the channels within a 4mm distance to the CTV boundary. 3) Dwell times for all the dwell positions are determined using an in-house developed inverse optimization algorithm. 5) The plan, and structure files are imported into the commercial treatment planning system via DICOM-RT interface, followed by further adjustment by the planner, if needed.

Results: We have tested the auto-planning module for the interstitial needle HDRBT in 8patient cases. It took approximately 4 minutes for applicator digitization and 1.54 +/- 0.85 minutes to generate a treatment plan. The applicators were successfully digitized with an error of less than 1 mm in all cases.

Conclusion: The auto-planning module has streamlined treatment planning of interstitial HDRBT for gynecological cancer and offered a new capability to the AutoBrachy system.


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