Abstract
PURPOSE: In this work, we propose to develop a 3D U-Net-based deep learning model that accurately predicts the dose distribution for breast cancer radiotherapy. METHODS: This study included 176 breast cancer patients, divided into training, validating and testing sets. A deep learning model based on the 3D U-Net architecture was developed to predict dose distribution, which employed a double encoder combination attention (DECA) module, a cross stage partial + Resnet + Attention (CRA) module, a difficulty perception and a critical regions loss. The performance and generalization ability of this model were evaluated by the voxel mean absolute error (MAE), several clinically relevant dosimetric indexes and 3D gamma passing rates. RESULTS: Our model accurately predicted the 3D dose distributions with each dosage level mirroring the clinical reality in shape. The generated dose-volume histogram (DVH) matched with the ground truth curve. The total dose error of our model was below 1.16 Gy, complying with clinical usage standards. When compared to other exceptional models, our model optimally predicted eight out of nine regions, and the prediction errors for the first planning target volume (PTV1) and PTV2 were merely 1.03 Gy and 0.74 Gy. Moreover, the mean 3%/3 mm 3D gamma passing rates for PTV1, PTV2, Heart and Lung L achieved 91.8%, 96.4%, 91.5%, and 93.2%, respectively, surpassing the other models and meeting clinical standards. CONCLUSIONS: This study developed a new deep learning model based on 3D U-Net that can accurately predict dose distributions for breast cancer radiotherapy, which can improve the quality and planning efficiency.