Human-like AI-based Auto-Field-in-Field Whole-Brain Radiotherapy Treatment Planning With Conversation Large Language Model Feedback

Fuente: arXiv
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Auteurs principaux: Jafar, Adnan, Qin, An, Atkins, Gavin, Hu, Xiaoyu, Gao, Yin, Jia, Xun
Format: Preprint
Publié: 2026
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author Jafar, Adnan
Qin, An
Atkins, Gavin
Hu, Xiaoyu
Gao, Yin
Jia, Xun
author_facet Jafar, Adnan
Qin, An
Atkins, Gavin
Hu, Xiaoyu
Gao, Yin
Jia, Xun
contents Whole-brain radiotherapy (WBRT) is a common treatment due to its simplicity and effectiveness. While automated Field-in-Field (Auto-FiF) functions assist WBRT planning in modern treatment planning systems, it still requires manual approaches for optimal plan generation including patient-specific hyperparameters definition and plan refinement based on quality feedback. This study introduces an automated WBRT planning pipeline that integrates a deep learning (DL) Hyperparameter Prediction model for patient-specific parameter generation and a large-language model (LLM)-based conversational interface for interactive plan refinement. The Hyperparameter Prediction module was trained on 55 WBRT cases using geometric features of clinical target volume (CTV) and organs at risk (OARs) to determine optimal Auto-FiF settings in RayStation treatment planning system. Plans were generated under predicted hyperparameters. For cases in which the generated plan was suboptimal, quality feedback via voice input was captured by a Conversation module, transcribed using Whisper, and interpreted by GPT-4o to adjust planning settings. Plan quality was evaluated in 15 independent cases using clinical metrics and expert review, and model explainability was supported through analysis of feature importance. Fourteen of 15 DL-generated plans were clinically acceptable. Normalized to identical CTV D95% as the clinical plans, the DL-generated and clinical plans showed no statistically significant differences in doses to the eyes, lenses, or CTV dose metrics D1% and D99%. The DL-based planning required under 1 minute of computation and achieved total workflow execution in approximately 7 minutes with a single mouse click, compared to 15 minutes for manual planning. In cases requiring adjustment, the Conversational module successfully improved dose conformity and hotspot reduction.
format Preprint
id arxiv_https___arxiv_org_abs_2601_00685
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Human-like AI-based Auto-Field-in-Field Whole-Brain Radiotherapy Treatment Planning With Conversation Large Language Model Feedback
Jafar, Adnan
Qin, An
Atkins, Gavin
Hu, Xiaoyu
Gao, Yin
Jia, Xun
Medical Physics
Whole-brain radiotherapy (WBRT) is a common treatment due to its simplicity and effectiveness. While automated Field-in-Field (Auto-FiF) functions assist WBRT planning in modern treatment planning systems, it still requires manual approaches for optimal plan generation including patient-specific hyperparameters definition and plan refinement based on quality feedback. This study introduces an automated WBRT planning pipeline that integrates a deep learning (DL) Hyperparameter Prediction model for patient-specific parameter generation and a large-language model (LLM)-based conversational interface for interactive plan refinement. The Hyperparameter Prediction module was trained on 55 WBRT cases using geometric features of clinical target volume (CTV) and organs at risk (OARs) to determine optimal Auto-FiF settings in RayStation treatment planning system. Plans were generated under predicted hyperparameters. For cases in which the generated plan was suboptimal, quality feedback via voice input was captured by a Conversation module, transcribed using Whisper, and interpreted by GPT-4o to adjust planning settings. Plan quality was evaluated in 15 independent cases using clinical metrics and expert review, and model explainability was supported through analysis of feature importance. Fourteen of 15 DL-generated plans were clinically acceptable. Normalized to identical CTV D95% as the clinical plans, the DL-generated and clinical plans showed no statistically significant differences in doses to the eyes, lenses, or CTV dose metrics D1% and D99%. The DL-based planning required under 1 minute of computation and achieved total workflow execution in approximately 7 minutes with a single mouse click, compared to 15 minutes for manual planning. In cases requiring adjustment, the Conversational module successfully improved dose conformity and hotspot reduction.
title Human-like AI-based Auto-Field-in-Field Whole-Brain Radiotherapy Treatment Planning With Conversation Large Language Model Feedback
topic Medical Physics
url https://arxiv.org/abs/2601.00685