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Radiation therapy is simple in its concept: high-energy radiation can damage and destroy cells, so beams of radiation are directed at a tumour to kill cancer cells. However, the treatment must also carefully minimize the dose to nearby organs.
Actually creating a plan that balances these conflicting requirements can be incredibly complex – it requires dedicated time from a team of highly-trained experts. Each patient's anatomy and tumour shape are unique, and it takes a lot of clinical resources and expertise to create a high-quality plan.
That may not be the case for much longer.
Dr. Thomas Purdie and his team, including Dr. Chris McIntosh, have used the power of artificial intelligence (AI) to develop a new system that can create a high-quality plan in minutes – instead of hours to days.
The technology uses machine learning to harvest information from a massive database of approved and peer-reviewed radiation therapy plans from the Princess Margaret Cancer Centre (PM).
While no two patients are identical, there can be similarities. The AI method evaluates many features in a patient's images, and finds other patients in the database with similar features. Then, it builds a personalized radiation therapy plan for the new patient based on information in the plans of patients with similar features.
With thousands of high-quality plans to learn from, the system rapidly adapts and optimizes the plan to suit the new patient, without requiring any user input during the process.
"The technology allows radiation medicine teams to take on more complex cases and provide precision medicine to more patients," says Dr. Purdie.
AI plan deemed 'superior' for that patient
Last month, the AI technology moved from just research to the clinic, actually impacting patient care. The clinical team, led by Dr. Alejandro Berlin, applied the AI technology developed at the Princess Margaret to treat a prostate cancer patient.
"The AI plan was deemed superior for that specific patient, and got the 'green light' after meeting all our protocol and quality assurance metrics," says Dr. Berlin, a radiation oncologist at PM who specializes in prostate cancer. "To the best of our knowledge, this is the first time anywhere that a patient has been actually treated with a radiation plan based only on AI technology.
"We are working on quantifying the impact and value of this AI method, as we we expect it will become the new paradigm of care for patients in the future."
The clinical team at PM is moving forward with a large-scale clinical roll out of the AI technology for planning radiation treatments this year, representing what is believed to be the single largest effort to make AI technology clinically used in radiation oncology.
Earlier this year, UHN announced that the AI technology has been licensed to RaySearch Laboratories of Sweden with the help of UHN's Technology Development and Commercialization Office. The AI algorithms developed at PM will be integrated into RaySearch's RayStation treatment planning system being released at the end of 2018.
"This technology has the potential to make a huge contribution to patient care," says Johan Löf, Chief Executive Officer of RaySearch. "I am delighted to be able to bring its benefits to centres around the world as part of the RayStation platform."