Without a clear definition of an optimal treatment plan, no optimization model can be perfect. Therefore, instead of automatically finding a single “optimal” plan, finding multiple, yet different near-optimal plans, can be an insightful approach to support radiation oncologists in finding the plan they are looking for. BRIGHT is a flexible AI-based optimization method for brachytherapy treatment planning that has already been shown capable of finding high-quality plans that trade-off target volume coverage and healthy tissue sparing. We leverage the flexibility of BRIGHT to find plans with similar dose-volume criteria, yet different dose distributions. We further describe extensions that facilitate fast plan adaptation should planning aims need to be adjusted, and straightforwardly allow incorporating hospital-specific aims besides standard protocols. Results are obtained for prostate ( = 12) and cervix brachytherapy ( = 36). We demonstrate the possible differences in dose distribution for optimized plans with equal dose-volume criteria. We furthermore demonstrate that adding hospital-specific aims enables adhering to hospital-specific practice while still being able to automatically create cervix plans that more often satisfy the EMBRACE-II protocol than clinical practice. Finally, we illustrate the feasibility of fast plan adaptation. Methods such as BRIGHT enable new ways to construct high-quality treatment plans for brachytherapy while offering new insights by making explicit the options one has. In particular, it becomes possible to present to radiation oncologists a manageable set of alternative plans that, from an optimization perspective are equally good, yet differ in terms of coverage-sparing trade-offs and shape of the dose distribution.

中文翻译：

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通过基于人工智能的前列腺和宫颈近距离放射治疗治疗规划，为您提供最佳选择

如果没有对最佳治疗计划的明确定义，任何优化模型都不可能是完美的。因此，与其自动寻找单个“最佳”计划，不如寻找多个但不同的接近最佳计划，这可能是支持放射肿瘤学家找到他们正在寻找的计划的富有洞察力的方法。 BRIGHT 是一种灵活的基于人工智能的近距离放射治疗计划优化方法，已被证明能够找到高质量的计划，在目标体积覆盖和健康组织保护之间进行权衡。我们利用 BRIGHT 的灵活性来寻找具有相似剂量体积标准但不同剂量分布的计划。我们进一步描述了在需要调整规划目标时促进快速计划调整的扩展，并直接允许除了标准方案之外纳入医院特定的目标。获得前列腺 (= 12) 和宫颈近距离放射治疗 (= 36) 的结果。我们证明了具有相同剂量体积标准的优化计划的剂量分布可能存在的差异。我们进一步证明，添加医院特定目标可以遵守医院特定实践，同时仍然能够自动创建比临床实践更能满足 EMBRACE-II 方案的子宫颈计划。最后，我们说明了快速计划适应的可行性。 BRIGHT 等方法提供了构建高质量近距离放射治疗计划的新方法，同时通过明确选择提供了新的见解。特别是，可以向放射肿瘤学家提供一组可管理的替代计划，从优化的角度来看，这些计划同样好，但在覆盖范围权衡和剂量分布形状方面有所不同。