论文标题

报告针对头部和颈部自适应质子疗法的AI注入轮廓工作流

Report on AI-Infused Contouring Workflows for Adaptive Proton Therapy in the Head and Neck

论文作者

Chaves-de-Plaza, Nicolas F., Mody, Prerak, Hildebrandt, Klaus, Staring, Marius, Astreinidou, Eleftheria, de Ridder, Mischa, de Ridder, Huib, van Egmond, Rene

论文摘要

在整个治疗过程中,对肿瘤和器官的诊断允许检测和纠正患者解剖结构的变化,使其成为适应性质子治疗(APT)的核心步骤。尽管基于AI的自动配置技术已经加强了此过程,但进行生成轮廓的质量评估(QA)所需的时间仍然是一种瓶颈,将临床医生在几分钟内最多一个小时的时间完成。本文介绍了一个适合于时间关键性恰当的快速轮廓工作流程,从而可以检测到较短的时间范围的解剖变化以及临床资源需求较低。拟议的AI注入的工作流程遵循在审查了APT文献并在荷兰两个放射疗法中心进行了几次访谈和一项观察性研究后发现的两个原则。首先,通过利用AI的不确定性和临床上与临床相关的特征(例如,危险危险的近端)来实现对生成的轮廓的有针对性检查。其次,最大程度地减少使用冗余含义的编辑工具编辑错误描述所需的交互数量,从而为用户提供可预测性和控制感。我们使用概念证明,我们与临床医生进行了验证,以证明当前和即将到来的AI功能如何支持工作流程以及如何适应临床实践。

Delineation of tumors and organs-at-risk permits detecting and correcting changes in the patients' anatomy throughout the treatment, making it a core step of adaptive proton therapy (APT). Although AI-based auto-contouring technologies have sped up this process, the time needed to perform the quality assessment (QA) of the generated contours remains a bottleneck, taking clinicians between several minutes up to an hour to complete. This paper introduces a fast contouring workflow suitable for time-critical APT, enabling detection of anatomical changes in shorter time frames and with a lower demand of clinical resources. The proposed AI-infused workflow follows two principles uncovered after reviewing the APT literature and conducting several interviews and an observational study in two radiotherapy centers in the Netherlands. First, enable targeted inspection of the generated contours by leveraging AI uncertainty and clinically-relevant features such as the proximity of the organs-at-risk to the tumor. Second, minimize the number of interactions needed to edit faulty delineations with redundancy-aware editing tools that provide the user a sense of predictability and control. We use a proof of concept that we validated with clinicians to demonstrate how current and upcoming AI capabilities support the workflow and how it would fit into clinical practice.

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