Technical note: Determining the applicability of a clinical knowledge-based learning model via prospective outlier detection.


Journal

Medical physics
ISSN: 2473-4209
Titre abrégé: Med Phys
Pays: United States
ID NLM: 0425746

Informations de publication

Date de publication:
Apr 2022
Historique:
revised: 17 01 2022
received: 18 11 2021
accepted: 20 01 2022
pubmed: 15 2 2022
medline: 14 4 2022
entrez: 14 2 2022
Statut: ppublish

Résumé

Knowledge-based planning (KBP) is increasingly implemented clinically because of its demonstrated ability to improve treatment planning efficiency and reduce plan quality variations. However, cases with large dose-volume histogram (DVH) prediction uncertainties may still need manual adjustments by the planner to achieve high plan quality. The purpose of this study is to develop a data-driven method to detect patients with high prediction uncertainties so that intentional effort is directed to these patients. We apply an anomaly detection method known as the local outlier factor (LOF) to a dataset consisting of the training set and each of the prospective patients considered, to evaluate their likelihood of being an anomaly when compared with the training cases. Features used in the LOF analysis include anatomical features and the model-generated DVH principal component scores. To test the efficacy of the proposed model, 142 prostate patients were retrieved from the clinical database and split into a training dataset of 100 patients and a test dataset of 42 patients. The outlier identification performance was quantified by the difference between the DVH prediction root-mean-squared errors (RMSE) of the identified outlier cases and that of the remaining inlier cases. With a predefined LOF threshold of 1.4, the inlier cases achieved average RMSEs of 5.0 and 6.7 for bladder and rectum, while the outlier cases have substantially higher RMSEs of 6.7 and 13.0 in comparison. We propose a method that can determine the prospective patient's outlier status. This method can be integrated into existing automated treatment planning workflows to reduce the risk of generating suboptimal treatment plans while providing an upfront alert to the treatment planner.

Sections du résumé

BACKGROUND BACKGROUND
Knowledge-based planning (KBP) is increasingly implemented clinically because of its demonstrated ability to improve treatment planning efficiency and reduce plan quality variations. However, cases with large dose-volume histogram (DVH) prediction uncertainties may still need manual adjustments by the planner to achieve high plan quality.
PURPOSE OBJECTIVE
The purpose of this study is to develop a data-driven method to detect patients with high prediction uncertainties so that intentional effort is directed to these patients.
METHODS METHODS
We apply an anomaly detection method known as the local outlier factor (LOF) to a dataset consisting of the training set and each of the prospective patients considered, to evaluate their likelihood of being an anomaly when compared with the training cases. Features used in the LOF analysis include anatomical features and the model-generated DVH principal component scores. To test the efficacy of the proposed model, 142 prostate patients were retrieved from the clinical database and split into a training dataset of 100 patients and a test dataset of 42 patients. The outlier identification performance was quantified by the difference between the DVH prediction root-mean-squared errors (RMSE) of the identified outlier cases and that of the remaining inlier cases.
RESULTS RESULTS
With a predefined LOF threshold of 1.4, the inlier cases achieved average RMSEs of 5.0 and 6.7 for bladder and rectum, while the outlier cases have substantially higher RMSEs of 6.7 and 13.0 in comparison.
CONCLUSIONS CONCLUSIONS
We propose a method that can determine the prospective patient's outlier status. This method can be integrated into existing automated treatment planning workflows to reduce the risk of generating suboptimal treatment plans while providing an upfront alert to the treatment planner.

Identifiants

pubmed: 35157318
doi: 10.1002/mp.15516
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2193-2202

Informations de copyright

© 2022 American Association of Physicists in Medicine.

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Auteurs

Jiahan Zhang (J)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Yang Sheng (Y)

Department of Radiation Oncology, Duke University, Durham, North Carolina, USA.

Jonathan Wolf (J)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Oluwatosin Kayode (O)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Jeffrey Bradley (J)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Yaorong Ge (Y)

Department of Software and Information Systems, The University of North Carolina at Charlotte, Charlotte, North Carolina, USA.

Q Jackie Wu (QJ)

Department of Radiation Oncology, Duke University, Durham, North Carolina, USA.

Xiaofeng Yang (X)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Tian Liu (T)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Justin Roper (J)

Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

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