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BrachyPlan: A fine-grained efficient dose-guided inverse planning strategy for low-dose-rate brachytherapy
Jiaxuan Liu1, Haitao Li2, Haochen Shi2
1Institute of Biomedical Manufacturing and Life Quality Engineering, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China; Department of Electronic, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Medical Image Analysis
|November 6, 2025
Summary
BrachyPlan automates low-dose-rate (LDR) brachytherapy planning using a novel Monte Carlo dose engine and inverse optimization. This framework significantly improves planning efficiency and dosimetric accuracy for various cancers.
Area of Science:
- Medical Physics
- Radiation Oncology
- Computational Biology
Background:
- Current brachytherapy treatment planning relies heavily on manual adjustments and dose calculation engines with questionable accuracy.
- This manual process is time-consuming and may compromise the precision of radiation delivery for malignancies like pancreatic and head-and-neck cancers.
Purpose of the Study:
- To introduce BrachyPlan, an automated end-to-end framework for low-dose-rate (LDR) brachytherapy planning.
- To enhance planning efficiency and maintain clinical precision in brachytherapy by integrating advanced computational methods.
Main Methods:
- Development of BrachyPlan, featuring a real-time Monte Carlo dose engine for high-fidelity, heterogeneity-aware dose mapping.
- Implementation of a dose-guided inverse-planning algorithm for optimal seed placement, adhering to target coverage and organ-at-risk constraints.
Main Results:
- BrachyPlan demonstrated <5% error in reproducing ground-truth Monte Carlo dose-volume histograms (DVHs) across all metrics in retrospective experiments.
- Achieved V100 >95% for all clinical targets and reduced planning time by 87.5% compared to manual workflows.
- The system requires minimal manual intervention, offering optimal efficiency and unprecedented planning speed.
Conclusions:
- BrachyPlan is the first platform to combine a clinically validated dose calculation algorithm with real-time inverse optimization for LDR brachytherapy.
- The framework delivers sub-5% dosimetric accuracy and significantly enhances planning efficiency, representing a major advancement in radiation oncology.
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