Evaluation of a deep learning-based pelvic synthetic CT generation technique for MRI-based prostate proton treatment planning

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Abstract
The purpose of this work is to validate the application of a deep learning-based method for pelvic synthetic CT (sCT) generation that can be used for prostate proton beam therapy treatment planning. We propose to integrate dense block minimization into 3D cycle-consistent generative adversarial networks (cycleGAN) framework to effectively learn the nonlinear mapping between MRI and CT pairs. A cohort of 17 patients with co-registered CT and MR pairs were used to test the deep learning-based sCT generation method by leave-one-out cross-validation. Image quality between the sCT and CT images, gamma analysis passing rate, dose-volume metrics, distal range displacement, and the individual pencil beam Bragg peak shift between sCT- and CT-based proton plans were evaluated. The average mean absolute error (MAE) was 51.32 ± 16.91 HU. The relative differences of the statistics of the PTV dose-volume histogram (DVH) metrics in between sCT and CT were generally less than 1%. Mean values of dose difference, absolute dose difference (in percent of the prescribed dose) were −0.07% ± 0.07% and 0.23% ± 0.08%. Mean gamma analysis pass rate of 1 mm/1%, 2 mm/2%, 3 mm/3% criteria with 10% dose threshold were 92.39% ± 5.97%, 97.95% ± 2.95% and 98.97% ± 1.62% respectively. The median, mean and standard deviation of absolute maximum range differences were 0.09 cm and 0.23 ± 0.25 cm. The median and mean Bragg peak shifts among the 17 patients were 0.09 cm and 0.18 ± 0.07 cm. The image similarity, dosimetric and distal range agreement between sCT and original CT suggests the feasibility of further development of an MRI-only workflow for prostate proton radiotherapy.
Funding Information
  • National Cancer Institute (R01CA215718)
  • Emory Winship Cancer Institute pilot grant

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