Generating Pareto Optimal Dose Distributions for Radiation Therapy Treatment Planning

Dan Nguyen, Azar Sadeghnejad Barkousaraie, Chenyang Shen, Xun Jia, Steve Jiang

Research output: Chapter in Book/Report/Conference proceedingConference contribution

15 Scopus citations


Radiotherapy treatment planning currently requires many trial-and-error iterations between the planner and treatment planning system, as well as between the planner and physician for discussion/consultation. The physician’s preferences for a particular patient cannot be easily quantified and precisely conveyed to the planner. In this study we present a real-time volumetric Pareto surface dose generation deep learning neural network that can be used after segmentation by the physician, adding a tangible and quantifiable endpoint to portray to the planner. From 70 prostate patients, we first generated 84,000 intensity modulated radiation therapy plans (1,200 plans per patient) sampling the Pareto surface, representing various tradeoffs between the planning target volume (PTV) and the organs-at-risk (OAR), including bladder, rectum, left femur, right femur, and body. We divided the data to 10 test patients and 60 training/validation patients. We then trained a hierarchically densely connected convolutional U-net (HD U-net), to take the PTV and avoidance map representing OARs masks and weights, and predict the optimized plan. The HD U-net is capable of accurately predicting the 3D Pareto optimal dose distributions, with average [mean, max] dose errors of [3.4%, 7.7%](PTV), [1.6%, 5.6%](bladder), [3.7%, 4.2%](rectum), [3.2%, 8.0%](left femur), [2.9%, 7.7%](right femur), and [0.04%, 5.4%](body) of the prescription dose. The PTV dose coverage prediction was also very similar, with errors of 1.3% (D98) and 2.0% (D99). Homogeneity was also similar, differing by 0.06 on average. The neural network can predict the dose within 1.7 s. Clinically, the optimization and dose calculation is much slower, taking 5–10 min.

Original languageEnglish (US)
Title of host publicationMedical Image Computing and Computer Assisted Intervention – MICCAI 2019 - 22nd International Conference, Proceedings
EditorsDinggang Shen, Pew-Thian Yap, Tianming Liu, Terry M. Peters, Ali Khan, Lawrence H. Staib, Caroline Essert, Sean Zhou
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages9
ISBN (Print)9783030322250
StatePublished - 2019
Event22nd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2019 - Shenzhen, China
Duration: Oct 13 2019Oct 17 2019

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume11769 LNCS
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349


Conference22nd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2019


  • Deep learning
  • Dose distribution
  • Intensity modulation
  • Neural network
  • Pareto surface
  • Radiation therapy treatment planning
  • U-net

ASJC Scopus subject areas

  • Theoretical Computer Science
  • Computer Science(all)


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