Artificial Intelligence-Based Radiotherapy Contouring and Planning to Improve Global Access to Cancer Care

Area of Science:

• Oncology
• Medical Physics
• Health Informatics

Background:

• Global cancer care disparities exist, particularly in low-resource settings.
• Automation in radiotherapy (RT) is a strategy to enhance cancer treatment accessibility and quality.
• The Radiation Planning Assistant (RPA) is a novel web-based tool developed to address these challenges.

Purpose of the Study:

• To assess the workflow and clinical acceptability of the Radiation Planning Assistant (RPA) tool.
• To evaluate the RPA's automated radiotherapy contouring and planning capabilities.
• To determine the global physician acceptance of RPA-generated plans.

Main Methods:

• A global cohort of 31 radiation oncologists from 16 institutions across six countries participated.
• Physicians reviewed RPA-generated contours and plans for 75 cancer cases.
• Clinical acceptability was rated using a 5-point Likert scale, assessing usability with and without minor edits.

Main Results:

• RPA plans demonstrated high acceptability across various cancer sites: cervical (81% usable as-is, 93% with edits), postmastectomy breast (44% usable as-is, 91% with edits), whole-brain (67% usable as-is, 99% with edits), and head/neck (89% autocontours usable as-is, 97% with edits).
• Clinical target volumes (CTVs) and volumetric-modulated arc therapy (VMAT) plans also showed high acceptability, particularly for cervical cancer (VMAT: 99% usable as-is, 100% with edits).
• Overall, RPA plans were frequently deemed clinically acceptable, often requiring only minor modifications.

Conclusions:

• The Radiation Planning Assistant (RPA) demonstrates significant clinical acceptability among international radiation oncologists.
• The tool shows strong potential for successful implementation in low-resource clinics, improving access to high-quality radiotherapy.
• RPA facilitates automated radiotherapy contouring and planning, contributing to global cancer care enhancement.