Flexible-CmGAN: Towards Precise 3D Dose Prediction in Radiotherapy

Deep learning has been utilized in knowledge-based radiotherapy planning in which a system trained with a set of clinically approved plans is employed to infer a three-dimensional dose map for a given new patient. However, previous deep methods are primarily limited to simple scenarios, e.g., a fixed planning type or a consistent beam angle configuration. This in fact limits the usability of such approaches and makes them not generalizable over a larger set of clinical scenarios. Herein, we propose a novel conditional generative model, Flexible-Cm GAN, utilizing additional information regarding planning types and various beam geometries. A miss-consistency loss is proposed to deal with the challenge of having a limited set of conditions on the input data, e.g., incomplete training samples. To address the challenges of including clinical preferences, we derive a differentiable shift-dose-volume loss to incorporate the well-known dose-volume histogram constraints. During inference, users can flexibly choose a specific planning type and a set of beam angles to meet the clinical requirements. We conduct experiments on an illustrative face dataset to show the motivation of Flexible-Cm GAN and further validate our model's potential clinical values with two radiotherapy datasets. The results demonstrate the superior performance of the proposed method in a practical heterogeneous radiotherapy planning application compared to existing deep learning-based approaches.