Clinical DVH metrics as a loss function for 3D dose prediction in head and neck radiotherapy
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arXiv
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| Autores principales: | , , |
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| Formato: | Preprint |
| Publicado: |
2026
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| _version_ | 1866912992129449984 |
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| author | Gao, Ruochen Staring, Marius Dankers, Frank |
| author_facet | Gao, Ruochen Staring, Marius Dankers, Frank |
| contents | Purpose: Deep-learning-based three-dimensional (3D) dose prediction is widely used in automated radiotherapy workflows. However, most existing models are trained with voxel-wise regression losses, which are poorly aligned with clinical plan evaluation criteria based on dose-volume histogram (DVH) metrics. This study aims to develop a clinically guided loss formulation that directly optimizes clinically used DVH metrics while remaining computationally efficient for head and neck (H\&N) dose prediction.
Methods: We propose a clinical DVH metric loss (CDM loss) that incorporates differentiable \textit{D-metrics} and surrogate \textit{V-metrics}, together with a lossless bit-mask region-of-interest (ROI) encoding to improve training efficiency. The method was evaluated on 174 H\&N patients using a temporal split (137 training, 37 testing).
Results: Compared with MAE- and DVH-curve based losses, CDM loss substantially improved target coverage and satisfied all clinical constraints. Using a standard 3D U-Net, the PTV Score was reduced from 1.544 (MAE) to 0.491 (MAE + CDM), while OAR sparing remained comparable. Bit-mask encoding reduced training time by 83\% and lowered GPU memory usage.
Conclusion: Directly optimizing clinically used DVH metrics enables 3D dose predictions that are better aligned with clinical treatment planning criteria than conventional voxel-wise or DVH-curve-based supervision. The proposed CDM loss, combined with efficient ROI bit-mask encoding, provides a practical and scalable framework for H\&N dose prediction. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2603_29670 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Clinical DVH metrics as a loss function for 3D dose prediction in head and neck radiotherapy Gao, Ruochen Staring, Marius Dankers, Frank Computer Vision and Pattern Recognition Purpose: Deep-learning-based three-dimensional (3D) dose prediction is widely used in automated radiotherapy workflows. However, most existing models are trained with voxel-wise regression losses, which are poorly aligned with clinical plan evaluation criteria based on dose-volume histogram (DVH) metrics. This study aims to develop a clinically guided loss formulation that directly optimizes clinically used DVH metrics while remaining computationally efficient for head and neck (H\&N) dose prediction. Methods: We propose a clinical DVH metric loss (CDM loss) that incorporates differentiable \textit{D-metrics} and surrogate \textit{V-metrics}, together with a lossless bit-mask region-of-interest (ROI) encoding to improve training efficiency. The method was evaluated on 174 H\&N patients using a temporal split (137 training, 37 testing). Results: Compared with MAE- and DVH-curve based losses, CDM loss substantially improved target coverage and satisfied all clinical constraints. Using a standard 3D U-Net, the PTV Score was reduced from 1.544 (MAE) to 0.491 (MAE + CDM), while OAR sparing remained comparable. Bit-mask encoding reduced training time by 83\% and lowered GPU memory usage. Conclusion: Directly optimizing clinically used DVH metrics enables 3D dose predictions that are better aligned with clinical treatment planning criteria than conventional voxel-wise or DVH-curve-based supervision. The proposed CDM loss, combined with efficient ROI bit-mask encoding, provides a practical and scalable framework for H\&N dose prediction. |
| title | Clinical DVH metrics as a loss function for 3D dose prediction in head and neck radiotherapy |
| topic | Computer Vision and Pattern Recognition |
| url | https://arxiv.org/abs/2603.29670 |