A method to combine target volume data from 3D and 4D planned thoracic radiotherapy patient cohorts for machine learning applications.

BACKGROUND AND PURPOSE The gross tumour volume (GTV) is predictive of clinical outcome and consequently features in many machine-learned models. 4D-planning, however, has prompted substitution of the GTV with the internal gross target volume (iGTV). We present and validate a method to synthesise GTV data from the iGTV, allowing the combination of 3D and 4D planned patient cohorts for modelling. MATERIAL AND METHODS Expert delineations in 40 non-small cell lung cancer patients were used to develop linear fit and erosion methods to synthesise the GTV volume and shape. Quality was assessed using Dice Similarity Coefficients (DSC) and closest point measurements; by calculating dosimetric features; and by assessing the quality of random forest models built on patient populations with and without synthetic GTVs. RESULTS Volume estimates were within the magnitudes of inter-observer delineation variability. Shape comparisons produced mean DSCs of 0.8817 and 0.8584 for upper and lower lobe cases, respectively. A model trained on combined true and synthetic data performed significantly better than models trained on GTV alone, or combined GTV and iGTV data. CONCLUSIONS Accurate synthesis of GTV size from the iGTV permits the combination of lung cancer patient cohorts, facilitating machine learning applications in thoracic radiotherapy.

[1]  Jan-Jakob Sonke,et al.  Variability of four-dimensional computed tomography patient models. , 2008, International journal of radiation oncology, biology, physics.

[2]  Bernard Dubray,et al.  Conformal radiotherapy for lung cancer: different delineation of the gross tumor volume (GTV) by radiologists and radiation oncologists. , 2002, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[3]  P. Lambin,et al.  Total gross tumor volume is an independent prognostic factor in patients treated with selective nodal irradiation for stage I to III small cell lung cancer. , 2013, International journal of radiation oncology, biology, physics.

[4]  Hemant Ishwaran,et al.  Random Survival Forests , 2008, Wiley StatsRef: Statistics Reference Online.

[5]  Ruijiang Li,et al.  Machine learning in radiation oncology : theory and applications , 2015 .

[6]  M. Kenward,et al.  Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls , 2009, BMJ : British Medical Journal.

[7]  R. Fisher,et al.  Measurement of lung tumor volumes using three-dimensional computer planning software. , 2002, International journal of radiation oncology, biology, physics.

[8]  P. Lambin,et al.  Learning methods in radiation oncology ‘Rapid Learning health care in oncology’ – An approach towards decision support systems enabling customised radiotherapy’ q , 2013 .

[9]  P. Lambin,et al.  Development, external validation and clinical usefulness of a practical prediction model for radiation-induced dysphagia in lung cancer patients. , 2010, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[10]  Jeffrey D Bradley,et al.  Bayesian network ensemble as a multivariate strategy to predict radiation pneumonitis risk. , 2015, Medical physics.

[11]  M. V. van Herk,et al.  Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. , 2002, International journal of radiation oncology, biology, physics.

[12]  Liesbeth Boersma,et al.  Microscopic disease extension in three dimensions for non-small-cell lung cancer: development of a prediction model using pathology-validated positron emission tomography and computed tomography features. , 2012, International journal of radiation oncology, biology, physics.

[13]  Max Kuhn,et al.  caret: Classification and Regression Training , 2015 .

[14]  C. Hess,et al.  The Impact of Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) Definition on the Total Accuracy in Radiotherapy , 2003, Strahlentherapie und Onkologie.

[15]  Shipeng Yu,et al.  Development and external validation of prognostic model for 2-year survival of non-small-cell lung cancer patients treated with chemoradiotherapy. , 2009, International journal of radiation oncology, biology, physics.

[16]  Udaya B. Kogalur,et al.  Random Survival Forests for R , 2007 .

[17]  P. Lambin,et al.  Predicting outcomes in radiation oncology—multifactorial decision support systems , 2013, Nature Reviews Clinical Oncology.

[18]  Masahiro Endo,et al.  Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer. , 2003, International journal of radiation oncology, biology, physics.

[19]  George Starkschall,et al.  Thoracic target volume delineation using various maximum-intensity projection computed tomography image sets for radiotherapy treatment planning. , 2010, Medical Physics (Lancaster).

[20]  Joseph O. Deasy,et al.  A Validated Prediction Model for Overall Survival From Stage III Non-Small Cell Lung Cancer: Toward Survival Prediction for Individual Patients , 2015, International journal of radiation oncology, biology, physics.

[21]  J. Sonke,et al.  Mid-ventilation based PTV margins in Stereotactic Body Radiotherapy (SBRT): a clinical evaluation. , 2014, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[22]  M. V. van Herk,et al.  Data Mining in Oncology: The ukCAT Project and the Practicalities of Working with Routine Patient Data. , 2017, Clinical oncology (Royal College of Radiologists (Great Britain)).

[23]  K. Lam,et al.  Uncertainties in CT-based radiation therapy treatment planning associated with patient breathing. , 1996, International journal of radiation oncology, biology, physics.

[24]  Michael Bremer,et al.  The delineation of target volumes for radiotherapy of lung cancer patients. , 2009, Radiotherapy and Oncology.

[25]  Arjan Bel,et al.  Definition of gross tumor volume in lung cancer: inter-observer variability. , 2002, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[26]  P. Lambin,et al.  Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach , 2014, Nature Communications.

[27]  Marcel van Herk,et al.  Observer variation in target volume delineation of lung cancer related to radiation oncologist-computer interaction: a 'Big Brother' evaluation. , 2005, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.