Direct Dose Prediction With Deep Learning for Postoperative Cervical Cancer Underwent Volumetric Modulated Arc Therapy

PURPOSE: To predict the voxel-based dose distribution for postoperative cervical cancer patients underwent volumetric modulated arc therapy using deep learning models. METHOD: A total of 254 patients with cervical cancer received volumetric modulated arc therapy in authors’ hospital from January 2018 to September 2021 were enrolled in this retrospective study. Two deep learning networks (3D deep residual neural network and 3DUnet) were adapted to train (203 cases) and test (51 cases) the feasibility and effectiveness of the prediction method. The performance of deep learning models was evaluated by comparing the results with those of treatment planning system according to metrics of dose-volume histogram of target volumes and organs at risk. RESULTS: The dose distributions predicted by deep learning models were clinically acceptable. The automatic dose prediction time was around 5 to 10 min, which was about one-eighth to one-tenth of the manual optimization time. The maximum dose difference was observed in D98 of rectum with a | δD| of 5.00 ± 3.40% and 4.88 ± 3.99% for Unet3D and ResUnet3D, respectively. The minimum difference was observed in the D2 of clinical target volume with a |δD| of 0.53 ± 0.45% and 0.83 ± 0.45% for ResUnet3D and Unet3D, respectively. CONCLUSION: The 2 deep learning models adapted in the study showed the feasibility and reasonable accuracy in the voxel-based dose prediction for postoperative cervical cancer underwent volumetric modulated arc therapy. Automatic dose distribution prediction of volumetric modulated arc therapy with deep learning models is of clinical significance for the postoperative management of patients with cervical cancer.