Deep Learning Based Multi-Label Classification of Radiotherapy Target Volumes for Prostate Cancer

Abstract: An initiative to standardize the nomenclature in Sweden started in 2016 along with the creation of the local database Medical Information Quality Archive (MIQA) and a national radiotherapy register on Information Network for CAncercare (INCA). A problem of identifying the clinical tumor volume (CTV) structures and prescribed dose arose when the consecutive number, which is added to the CTV-name, was made inconsistently in MIQA and INCA. Deep neural networks (DNN) were promising tools to solve the multi-label classification task of the CTV to enable automatic labeling in the database. Prostate cancer patients that often have more than one type of organ in the same CTV structure were chosen for proof of concept. The DNN used supervised training in a 2D fashion where the radiation therapy (RT) structures along with the CT image were fed, slice by slice, to AlexNet and VGGNet to label the CTV structures in the local database system MIQA and INCA. The study also includes three methods to classify a final label for the CTV structure since the model makes the predictions on each slice. The three methods were maximum method by taking the maximum prediction for each class, minimum method by taking the minimum prediction for each class and occurrence method. The occurrence method chooses the maximum prediction if the network has predicted the class over 0.5 at least two times and the minimum prediction if not. The DNN and volume classification methods performed well where the maximum and occurrence method performed the best and can be used to interpret RT volumes in MIQA and INCA for prostate cancer patients. This novel study gives promising results for the future development of deep neural networks classifying RT structures for more than one type of cancer patient.