Automated plan generation for prostate radiotherapy patients using deep learning and scripted optimization.

Background and Purpose: Treatment planning is a time-intensive task that could be automated. We aimed to develop a "single-click" workflow, fully deployed within a commercial treatment planning system (TPS), for autoplanning prostate radiotherapy treatment plans using predictions from a deep learning model (DLM). Materials and Methods: Automatically generated treatment plans were created with a single script, executed from within a commercial TPS scripting environment, that performed two stages sequentially. Initially, a 3D dose distribution was predicted with a ResUNet DLM. The DLM was trained and validated using previously treated datasets (n = 120) which used 3D contours as inputs. Following this, dose predictions were converted into treatment plans by extracting dose-volume metrics from the predictions to use as objectives for the inverse optimizer within the TPS. An independent test dataset (n = 20) was used to evaluate the similarity between automated and clinical plans. Results: For planning target volumes, the median percentage difference and interquartile range between the automatically generated plans and clinical plans were 0.4% [0.2-1.1%] for the V Conclusions: An automatic plan generation workflow that uses a DL model with scripted optimization was fully deployed in a commercial TPS. Autoplans were compared to previously treated clinical plans and were found to be non-inferior.