论文标题
放射疗法中的全工作流程自动化的首次实施：直肠癌的多合一解决方案
First implementation of full-workflow automation in radiotherapy: the All-in-One solution on rectal cancer
论文作者
论文摘要
这项工作的目的是描述AI驱动的放射疗法工作流的技术特征，该工作流程能够实现全部过程自动化（全合一），评估其为直肠癌进行造成的初始治疗的性能，并深入了解放射治疗专业中全部工作流动自动化的行为。基于CT集成线性加速器开发了多合一的工作流程。它将常规放疗程序从模拟，自动分组，自动镀料，图像指导，束输送和体内质量保证（QA）中纳入一个方案，其中涉及关键决策点，而患者在整个过程中处于治疗沙发上。对于入学的十名直肠癌患者，需要对自动靶标体积进行较小的修饰，并且在修饰前后的骰子相似性系数和95％的Hausdorff距离分别为0.892 {\ pm} 0.061和18.2 {\ pm} 13.0 mm。自动序列的正常组织和自动计划在临床上是可以接受的，而无需进行任何修改或重新优化。预处理的IGRT校正在所有方向上都在2 mm之内，并且基于Epid的体内质量质量质量质量质量量优于97 {\％}（3 {\％}/3 mm/10 {\％}阈值）。整个过程的持续时间为23.2 {\ pm} 3.5分钟，主要取决于手动修改和计划评估所需的时间。多合一的工作流可以通过无缝整合多个常规程序来完全自动化整个放射疗法过程。一站式解决方案缩短了准备第一次治疗的时间尺度从几天到几分钟，从而显着提高了患者的体验和工作流程的效率，并显示出促进在线自适应重新植物的临床应用的潜力。
The aim of this work is to describe the technical characteristics of an AI-powered radiotherapy workflow that enables full-process automation (All-in-One), evaluate its performance implemented for on-couch initial treatment of rectal cancer, and provide insight into the behavior of full-workflow automation in the specialty of radiotherapy. The All-in-One workflow was developed based on a CT-integrated linear accelerator. It incorporates routine radiotherapy procedures from simulation, autosegmentation, autoplanning, image guidance, beam delivery, and in vivo quality assurance (QA) into one scheme, with critical decision points involved, while the patient is on the treatment couch during the whole process. For the enrolled ten patients with rectal cancer, minor modifications of the autosegmented target volumes were required, and the Dice similarity coefficient and 95% Hausdorff distance before and after modifications were 0.892{\pm}0.061 and 18.2{\pm}13.0 mm, respectively. The autosegmented normal tissues and automatic plans were clinically acceptable without any modifications or reoptimization. The pretreatment IGRT corrections were within 2 mm in all directions, and the EPID-based in vivo QA showed a γ passing rate better than 97{\%} (3{\%}/3 mm/10{\%} threshold). The duration of the whole process was 23.2{\pm}3.5 minutes, depending mostly on the time required for manual modification and plan evaluation. The All-in-One workflow enables full automation of the entire radiotherapy process by seamlessly integrating multiple routine procedures. The one-stop solution shortens the time scale it takes to ready the first treatment from days to minutes, significantly improving the patient experience and the efficiency of the workflow, and shows potential to facilitate the clinical application of online adaptive replanning.
