Organ sample generator for expected treatment dose construction and adaptive inverse planning optimization

摘要

Purpose: To create an organ sample generator (OSG) for expected treatment dose construction and adaptive inverse planning optimization. The OSG generates random samples of organs of interest from a distribution obeying the patient specific organ variation probability density function (PDF) during the course of adaptive radiotherapy. Methods: Principle component analysis (PCA) and a time-varying least-squares regression (LSR) method were used on patient specific geometric variations of organs of interest manifested on multiple daily volumetric images obtained during the treatment course. The construction of the OSG includes the determination of eigenvectors of the organ variation using PCA, and the determination of the corresponding coefficients using time-varying LSR. The coefficients can be either random variables or random functions of the elapsed treatment days depending on the characteristics of organ variation as a stationary or a nonstationary random process. The LSR method with time-varying weighting parameters was applied to the precollected daily volumetric images to determine the function form of the coefficients. Eleven hn cancer patients with 30 daily cone beam CT images each were included in the evaluation of the OSG. The evaluation was performed using a total of 18 organs of interest, including 15 organs at risk and 3 targets. Results: Geometric variations of organs of interest during hn cancer radiotherapy can be represented using the first 3 ～ 4 eigenvectors. These eigenvectors were variable during treatment, and need to be updated using new daily images obtained during the treatment course. The OSG generates random samples of organs of interest from the estimated organ variation PDF of the individual. The accuracy of the estimated PDF can be improved recursively using extra daily image feedback during the treatment course. The average deviations in the estimation of the mean and standard deviation of the organ variation PDF for hn cancer radiotherapy were less than 2 and 1 mm, respectively, for most organs after the second week of treatment. After the first three weeks of treatment, the mean discrepancy of the dose estimation accuracy was within 1 for most of organs, the corresponding standard deviation was within 2.5 for parotids, the brain stem and the cochleae, and within 1 for other organs. Conclusions: A patient specific OSG is feasible and can be used to generate random samples of organs of interest for the expected treatment dose construction and adaptive inverse planning. The accuracy of the OSG can be improved continuously and recursively during the adaptive treatment course using daily volumetric image feedback.