Clinical commissioning and introduction of an in-house artificial intelligence (AI) platform for automated head and neck intensity modulated radiation therapy (IMRT) treatment planning

Background and purpose: To describe the clinical commissioning of an in-house artificial intelligence (AI) treatment planning platform for head-and-neck (HN) Intensity Modulated Radiation Therapy (IMRT).

Materials and methods: The AI planning platform has three components: (1) a graphical user interface (GUI) is built within the framework of a commercial treatment planning system (TPS). The GUI allows AI models to run remotely on a designated workstation configured with GPU acceleration. (2) A template plan is automatically prepared involving both clinical and AI considerations, which include contour evaluation, isocenter placement, and beam/collimator jaw placement. (3) A well-orchestrated suite of AI models predicts optimal fluence maps, which are imported into TPS for dose calculation followed by an optional automatic fine-tuning. Six AI models provide flexible tradeoffs in parotid sparing and Planning Target Volume (PTV)-organ-at-risk (OAR) preferences. Planners could examine the plan dose distribution and make further modifications as clinically needed. The performance of the AI plans was compared to the corresponding clinical plans.

Results: The average plan generation time including manual operations was 10-15 min per case, with each AI model prediction taking ∼1 s. The six AI plans form a wide range of tradeoff choices between left and right parotids and between PTV and OARs compared with corresponding clinical plans, which correctly reflected their tradeoff designs.

Conclusion: The in-house AI IMRT treatment planning platform was developed and is available for clinical use at our institution. The process demonstrates outstanding performance and robustness of the AI platform and provides sufficient validation.