Outline of Topics and Discussions 2023/01/17

By Tomoyuki Kakutani

Class started by lecture around 30 minutes, after that we discussed several questions regarding

the topic. Class ended by wrap up from the lecturer.

Current status of radiotherapy technique and radiotherapy AI

Every year, about 367,000 new cases of cancer are diagnosed in the UK. Since the

1990s, the incidence has risen by 12–16% and is still rising. A patient's cancer

management depends more and more on medical imaging. The amount of imaging data

available to clinicians is rising as the incidence of cancer diagnosis rises. Because more

image-guided planning is needed for advanced treatment choices like adaptive

radiotherapy (RT) planning, the volume of data will keep growing. The quantitative

mining of imaging further expands the data's accessibility. Radiation oncology may

undergo significant change as a result of connected data production and artificial

intelligence (AI), with the potential to democratize the discipline.

The development of autonomous systems that mimic human functions is the focus of

the branch of computer science known as artificial intelligence (AI). The process of

resolving real-world issues by creating statistical models from a dataset obtained in the

past is known as machine learning, a subfield of artificial intelligence that is the subject

of this article. These statistical models generate predictions by "learning" from collected

data. Deep learning is a subset of machine learning that uses neurons in neural networks

to mimic the functions of the human brain to aid with decision-making.

Each neuron in the network learns a straightforward function, and by integrating these

straightforward functions, the total (more complex) function is determined.

AI developments have increased efforts to automate jobs that are typically performed by

human observers. Automation has the potential to improve patient care by lowering

costs, boosting productivity, and minimizing errors. Planning for conformal brain

radiation (RT), for instance, can take two to four hours. Planning radiologists can

perform the contouring of Organs at Risk (OAR), whereas Advanced Practitioner and

Consultant radiologists have a specific set of skills for performing the contouring of

Gross Tumor Volume (GTV). While OAR contouring is not as time-consuming as GTV

or Metabolic Tumor Volume (MTV) delineation, it is nonetheless vulnerable to greater

inter- and intraobserver variability.

To lessen this clinical strain and enable the redistribution of important healthcare

resources, administrative and routine clinical tasks like OAR contouring can be

automated. Prioritizing time-critical dependent scenarios is another way AI is being

used to improve healthcare outcomes and make more time available for tasks that are

most important to patients and people. As an illustration, AI has been used to partition

OAR and to prioritize individuals who are at high risk of getting colon cancer.

In radiation oncology, artificial intelligence (AI) has considerable promise for toxicity

prediction, automated RT planning and optimization, clinical trial patient selection, and

clinical burden reduction. To educate and train the radiation workforce in data

provenance, curation, and integration as well as the ethics of AI development and the
interpretation of AI technologies, resources are, nevertheless, needed. For instance, by

introducing the fundamentals of clinical data science and AI to therapeutic radiologists

earlier in their careers, the appropriate degree of knowledge could be attained. The

integration of knowledge between professionals and AI experts would also be possible

with continuing continued professional growth. As a result, there will be more

confidence in the technologies because the black-box impact of AI will be diminished.

Additionally, by giving radiologists and doctors access to these training materials, we

can aid them in discovering novel applications for AI. By using these technologies,

clinicians may be able to identify patterns in local, regional, and global populations that

are not always obvious to the naked eye. However, patients should be included in the

development and deployment of these technologies, ensuring that the "do no harm"

concept is always upheld.

It is also necessary to report challenge events and technical publications consistently.

Comparing AI systems can be made easier for the radiotherapy workforce by

conformance to CLAIM guideline. The therapeutic efficacy of these technologies also

needs to be thoroughly evaluated using prospective and qualitative investigations. A

common scenario in clinical research employing patient outcomes is the evaluation of

standardized endpoints between AI investigations. There is promise for the eventual

clinical application of these technologies, even if AI still has a long way to go in terms

of overcoming significant obstacles like lack of generalizability, tiny datasets, and a

lack of prospective validation trials. Utilizing hype curves, Netherton et al.75 project

that 20% of clinics will be using AI within the next three years. To do this, however,

will call for more open and consistent reporting of AI model performance, vendor
integration of commercial technologies with existing NHS IT systems, and increased

connectivity across healthcare providers.

AI could use the growing amount of data that clinical practitioners have access to. The

accessibility of instructional materials for healthcare professionals, the ethics of AI

development, and the interpretation of AI technology, however, remain significantly out

of sync.