Neural Network-Driven Direct CBCT-Based Dose Calculation for Head-and-Neck Proton Treatment Planning

• URL: http://arxiv.org/abs/2509.18378v1
• Date: Mon, 22 Sep 2025 20:01:32 GMT
• Title: Neural Network-Driven Direct CBCT-Based Dose Calculation for Head-and-Neck Proton Treatment Planning
• Authors: Muheng Li, Evangelia Choulilitsa, Lisa Fankhauser, Francesca Albertini, Antony Lomax, Ye Zhang,
• Abstract summary: Dose calculation on cone beam computed tomography (CBCT) images is essential for modern proton treatment planning.<n>Traditional CBCT-based dose calculation suffers from image quality limitations, requiring complex correction.<n>This study develops and validates a deep learning approach for direct proton dose calculation from CBCT images.
• Score: 5.972646198959602
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Accurate dose calculation on cone beam computed tomography (CBCT) images is essential for modern proton treatment planning workflows, particularly when accounting for inter-fractional anatomical changes in adaptive treatment scenarios. Traditional CBCT-based dose calculation suffers from image quality limitations, requiring complex correction workflows. This study develops and validates a deep learning approach for direct proton dose calculation from CBCT images using extended Long Short-Term Memory (xLSTM) neural networks. A retrospective dataset of 40 head-and-neck cancer patients with paired planning CT and treatment CBCT images was used to train an xLSTM-based neural network (CBCT-NN). The architecture incorporates energy token encoding and beam's-eye-view sequence modelling to capture spatial dependencies in proton dose deposition patterns. Training utilized 82,500 paired beam configurations with Monte Carlo-generated ground truth doses. Validation was performed on 5 independent patients using gamma analysis, mean percentage dose error assessment, and dose-volume histogram comparison. The CBCT-NN achieved gamma pass rates of 95.1 $\pm$ 2.7% using 2mm/2% criteria. Mean percentage dose errors were 2.6 $\pm$ 1.4% in high-dose regions ($>$90% of max dose) and 5.9 $\pm$ 1.9% globally. Dose-volume histogram analysis showed excellent preservation of target coverage metrics (Clinical Target Volume V95% difference: -0.6 $\pm$ 1.1%) and organ-at-risk constraints (parotid mean dose difference: -0.5 $\pm$ 1.5%). Computation time is under 3 minutes without sacrificing Monte Carlo-level accuracy. This study demonstrates the proof-of-principle of direct CBCT-based proton dose calculation using xLSTM neural networks. The approach eliminates traditional correction workflows while achieving comparable accuracy and computational efficiency suitable for adaptive protocols.

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