Machine learning multicriteria optimization in radiation therapy treatment planning

Sammanfattning: In radiation therapy treatment planning, recent works have used machine learning based on historically delivered plans to automate the process of producing clinically acceptable plans. Compared to traditional approaches such as repeated weighted-sum optimization or multicriteria optimization (MCO), automated planning methods have, in general, the benefits of low computational times and minimal user interaction, but on the other hand lack the flexibility associated with general-purpose frameworks such as MCO. Machine learning approaches can be especially sensitive to deviations in their dose prediction due to certain properties of the optimization functions usually used for dose mimicking and, moreover, suffer from the fact that there exists no general causality between prediction accuracy and optimized plan quality.In this thesis, we present a means of unifying ideas from machine learning planning methods with the well-established MCO framework. More precisely, given prior knowledge in the form of either a previously optimized plan or a set of historically delivered clinical plans, we are able to automatically generate Pareto optimal plans spanning a dose region corresponding to plans which are achievable as well as clinically acceptable. For the former case, this is achieved by introducing dose--volume constraints; for the latter case, this is achieved by fitting a weighted-data Gaussian mixture model on pre-defined dose statistics using the expectation--maximization algorithm, modifying it with exponential tilting and using specially developed optimization functions to take into account prediction uncertainties.Numerical results for conceptual demonstration are obtained for a prostate cancer case with treatment delivered by a volumetric-modulated arc therapy technique, where it is shown that the methods developed in the thesis are successful in automatically generating Pareto optimal plans of satisfactory quality and diversity, while excluding clinically irrelevant dose regions. For the case of using historical plans as prior knowledge, the computational times are significantly shorter than those typical of conventional MCO.