# A GPU-based multi-criteria optimization algorithm for HDR brachytherapy

## TL;DR

This paper introduces a GPU-based multi-criteria optimization algorithm for HDR prostate brachytherapy that significantly improves plan quality and reduces planning time compared to traditional manual methods.

## Contribution

The study presents a novel GPU-accelerated inverse planning algorithm, gMCO, utilizing gL-BFGS optimization to generate high-quality treatment plans efficiently.

## Key findings

- gMCO achieved 99.8% clinically valid plans, outperforming clinical plans at 92.6%.
- The algorithm generated 1000 Pareto optimal plans in approximately 9.4 seconds.
- Treatment plan quality was improved and planning time was significantly reduced.

## Abstract

Currently in HDR brachytherapy planning, a manual fine-tuning of an objective function is necessary to obtain case-specific valid plans. This study intends to facilitate this process by proposing a patient-specific inverse planning algorithm for HDR prostate brachytherapy: GPU-based multi-criteria optimization (gMCO). Two GPU-based optimization engines including simulated annealing (gSA) and a quasi-Newton optimizer (gL-BFGS) were implemented to compute multiple plans in parallel. After evaluating the equivalence and the computation performance of these two optimization engines, one preferred optimization engine was selected for the gMCO algorithm. Five hundred sixty-two previously treated prostate HDR cases were divided into validation set (100) and test set (462). In the validation set, the number of Pareto optimal plans to achieve the best plan quality was determined for the gMCO algorithm. In the test set, gMCO plans were compared with the physician-approved clinical plans. Over 462 cases, the number of clinically valid plans was 428 (92.6%) for clinical plans and 461 (99.8%) for gMCO plans. The number of valid plans with target V100 coverage greater than 95% was 288 (62.3%) for clinical plans and 414 (89.6%) for gMCO plans. The mean planning time was 9.4 s for the gMCO algorithm to generate 1000 Pareto optimal plans. In conclusion, gL-BFGS is able to compute thousands of SA equivalent treatment plans within a short time frame. Powered by gL-BFGS, an ultra-fast and robust multi-criteria optimization algorithm was implemented for HDR prostate brachytherapy. A large-scale comparison against physician approved clinical plans showed that treatment plan quality could be improved and planning time could be significantly reduced with the proposed gMCO algorithm.