title: Evaluation and scoring of radiotherapy treatment plans using an artificial neural network.
abstract: OBJECTIVE
  The objective of this work was to demonstrate the feasibility of using an artificial neural network to predict the clinical evaluation of radiotherapy treatment plans.
  
  
  METHODS
  Approximately 150 treatment plans were developed for 16 patients who received external-beam radiotherapy for soft-tissue sarcomas of the lower extremity. Plans were assigned a figure of merit by a radiation oncologist using a five-point rating scale. Plan scoring was performed by a single physician to ensure consistency in rating. Dose-volume information extracted from a training set of 511 treatment plans on 14 patients was correlated to the physician-generated figure of merit using an artificial neural network. The neural network was tested with a test set of 19 treatment plans on two patients whose plans were not used in the training of the neural net.
  
  
  RESULTS
  Physician scoring of treatment plans was consistent to within one point on the rating scale 88% of the time. The neural net reproduced the physician scores in the training set to within one point approximately 90% of the time. It reproduced the physician scores in the test set to within one point approximately 83% of the time.
  
  
  CONCLUSIONS
  An artificial neural network can be trained to generate a score for a treatment plan that can be correlated to a clinically-based figure of merit. The accuracy of the neural net in scoring plans compares well with the reproducibility of the clinical scoring. The system of radiotherapy treatment plan evaluation using an artificial neural network demonstrates promise as a method for generating a clinically relevant figure of merit.
authors.affiliation: Department of Radiation Physics, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Willoughby
authors.forename: G
authors.initials: G
authors.lastname: Starkschall
authors.forename: N A
authors.initials: NA
authors.lastname: Janjan
authors.forename: I I
authors.initials: II
authors.lastname: Rosen
mesh_terms: D005240:Feasibility Studies; D006801:Humans; D007866:Leg; D016571:Neural Networks, Computer; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012509:Sarcoma / Q000532:radiotherapy*