AI End-to-End Radiation Treatment Planning Under One Second

TL;DR

This paper presents AIRT, an AI framework that generates deliverable prostate radiotherapy plans from CT images in under one second, significantly reducing planning time and maintaining quality.

Contribution

The introduction of an end-to-end deep learning model capable of producing clinically acceptable treatment plans in under one second is a novel advancement.

Findings

Generated plans are non-inferior to RapidPlan Eclipse in target coverage.

Achieved target homogeneity and OAR sparing comparable to reference plans.

Demonstrated ultra-fast plan generation on a single GPU.

Abstract

Artificial intelligence-based radiation therapy (RT) planning has the potential to reduce planning time and inter-planner variability, improving efficiency and consistency in clinical workflows. Most existing automated approaches rely on multiple dose evaluations and corrections, resulting in plan generation times of several minutes. We introduce AIRT (Artificial Intelligence-based Radiotherapy), an end-to-end deep-learning framework that directly infers deliverable treatment plans from CT images and structure contours. AIRT generates single-arc VMAT prostate plans, from imaging and anatomical inputs to leaf sequencing, in under one second on a single Nvidia A100 GPU. The framework includes a differentiable dose feedback, an adversarial fluence map shaping, and a plan generation augmentation to improve plan quality and robustness. The model was trained on more than 10,000 intact prostate cases. Non-inferiority to RapidPlan Eclipse was demonstrated across target coverage and OAR sparing metrics. Target homogeneity (HI = 0.10 $\pm$ 0.01) and OAR sparing were similar to reference plans when evaluated using AcurosXB. These results represent a significant step toward ultra-fast standardized RT planning and a streamlined clinical workflow.