Improving Observed Decisions Quality using Inverse Optimization: A Radiation Therapy Treatment Planning Application

TL;DR

This paper introduces an inverse optimization model to enhance radiation therapy plans by improving dose distributions while preserving clinical constraints, demonstrating better organ sparing without losing target coverage.

Contribution

The paper presents a novel inverse optimization framework that learns from existing plans to generate improved radiation therapy treatment plans, balancing feasibility and optimality.

Findings

Improved dose-volume histograms for prostate cancer patients

Enhanced organ-at-risk sparing without compromising target coverage

Flexible approach applicable to multiple organs and constraints

Abstract

In many applied optimization settings, parameters that define the constraints may not guarantee the best possible solution, and superior solutions might exist that are infeasible for the given parameter values. Removing such constraints, re-optimizing, and evaluating the new solution may be insufficient, as the optimizer's preferences in selecting the existing solutions might be lost. To address this issue, we present an inverse optimization-based model that takes an observed solution as input and aims to improve upon it by projecting onto desired hyperplanes or expanding the feasible set while balancing the distance to the observed decision to preserve the optimizer's preferences. We demonstrate the applicability of the model in the context of radiation therapy treatment planning, an essential component of cancer treatment. Radiation therapy treatment planning is typically guided by expert-driven guidelines that define the optimization problem but remain mostly general. Our model provides an automated framework that learns new plans from available plans based on given clinical criteria, optimizing the desired effect without compromising the remaining constraints. The proposed approach is applied to a cohort of four prostate cancer patients, and the results demonstrate improvements in dose-volume histograms while maintaining comparable target coverage to clinically acceptable plans. By optimizing the parameters of the treatment planning problem and exploring the Pareto frontier, our methodology uncovers previously unattainable solutions that enhance organ-at-risk sparing without sacrificing target coverage. The framework's ability to handle multiple organs-at-risk and various dose-volume constraints highlights its flexibility and potential for application to diverse radiation therapy treatment planning scenarios.