{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:48:50Z","timestamp":1790423330817,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007210","name":"Varian Medical Systems","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In recent years, deep\u2010learning models have been used to predict entire three\u2010dimensional dose distributions. However, the usability of dose predictions to improve plan quality should be further investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To develop a deep\u2010learning model to predict high\u2010quality dose distributions for volumetric modulated arc therapy (VMAT) plans for patients with gynecologic cancer and to evaluate their usability in driving plan quality improvements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 79 VMAT plans for the female pelvis were used to train (47 plans), validate (16 plans), and test (16 plans) 3D dense dilated U\u2010Net models to predict 3D dose distributions. The models received the normalized CT scan, dose prescription, and target and normal tissue contours as inputs. Three models were used to predict the dose distributions for plans in the test set. A radiation oncologist specializing in the treatment of gynecologic cancers scored the test set predictions using a 5\u2010point scale (5, acceptable as\u2010is; 4, prefer minor edits; 3, minor edits needed; 2, major edits needed; and 1, unacceptable). The clinical plans for which the dose predictions indicated that improvements could be made were reoptimized with constraints extracted from the predictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The predicted dose distributions in the test set were of comparable quality to the clinical plans. The mean voxel\u2010wise dose difference was \u22120.14\u00a0\u00b1\u00a00.46\u00a0Gy. The percentage dose differences in the predicted target metrics of  and  were \u22121.05%\u00a0\u00b1\u00a00.59% and 0.21%\u00a0\u00b1\u00a00.28%, respectively. The dose differences in the predicted organ at risk mean and maximum doses were \u22120.30\u00a0\u00b1\u00a01.66\u00a0Gy and \u22120.42\u00a0\u00b1\u00a02.07\u00a0Gy, respectively. A radiation oncologist deemed all of the predicted dose distributions clinically acceptable; 12 received a score of 5, and four received a score of 4. Replanning of flagged plans (five plans) showed that the original plans could be further optimized to give dose distributions close to the predicted dose distributions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Deep\u2010learning dose prediction can be used to predict high\u2010quality and clinically acceptable dose distributions for VMAT female pelvis plans, which can then be used to identify plans that can be improved with additional optimization.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16735","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:24:36Z","timestamp":1694712276000},"page":"6639-6648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Deep learning\u2013based dose prediction to improve the plan quality of volumetric modulated arc therapy for gynecologic cancers"],"prefix":"10.1002","volume":"50","author":[{"given":"Mary P.","family":"Gronberg","sequence":"first","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuja","family":"Jhingran","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tucker J.","family":"Netherton","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skylar S.","family":"Gay","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fuentes","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"},{"name":"Department of Imaging Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton D.","family":"Fuller","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"},{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Yee","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Marquez","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adenike M.","family":"Olanrewaju","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine B.","family":"Peterson","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"},{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Wooten","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"Department of Statistics Rice University  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence E.","family":"Court","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics The University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2011.11.012"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2022.12.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2013.11.004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3539749"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4757927"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15516"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4761864"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4906183"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13614"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-015-0542-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.01.046"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab039b"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13271"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13262"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15034"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13490"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.03.012"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14774"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14827"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-021-01864-9"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2021.01.006"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2021.02.021"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-32486-5_9"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2021.02.026"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13597"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.11.026"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13583"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aaef74"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2021.07.008"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.10.027"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.05.005"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-022-02155-7"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/15330338231167039"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14467"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14845"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.16735","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T17:47:47Z","timestamp":1699379267000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.16735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,14]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1002\/mp.16735"],"URL":"https:\/\/doi.org\/10.1002\/mp.16735","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,14]]},"assertion":[{"value":"2023-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}