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Radiotherapy inverse planning often requires planners to modify parameters in the treatment planning system's objective function to produce clinically acceptable plans. Due to the manual steps in this process, plan quality can vary depending on the planning time available and the planner's skills. This study investigates two hyperparameter-tuning methods for automated inverse planning. Because this framework does not train a model on previously-optimized plans, it can be readily adapted to practice pattern changes, and plan quality is not limited by that of a training cohort. We selected 10 patients who received lung SBRT using manually-generated clinical plans. We used random sampling (RS) and Bayesian optimization (BO) to tune parameters using linear-quadratic utility functions based on 11 clinical goals. Normalizing all plans to have PTV D95 equal to 48 Gy, we compared plan quality for the automatically-generated and manually-generated plans. We also investigated the impact of iteration count on the automatically-generated plans, comparing planning time and plan utility for RS and BO plans with and without stopping criteria. Without stopping criteria, the median planning time was 1.9 and 2.3 hours for RS and BO plans. The OAR doses in the RS and BO plans had a median percent difference (MPD) of 48.7% and 60.4% below clinical dose limits and an MPD of 2.8% and 3.3% below clinical plan doses. With stopping criteria, the utility decreased by an MPD of 5.3% and 3.9% for RS and BO plans, but the median planning time was reduced to 0.5 and 0.7 hours, and the OAR doses still had an MPD of 42.9% and 49.7% below clinical dose limits and an MPD of 0.3% and 1.8% below clinical plan doses. This study demonstrates that hyperparameter-tuning approaches to automated inverse planning can reduce active planning time with plan quality that is similar to or better than manually-generated plans., Comment: 22 pages, 4 figures

Estimating temporal patterns in travel times along road segments in urban settings is of central importance to traffic engineers and city planners. In this work, we propose a methodology to leverage coarse-grained and aggregated travel time data to estimate the street-level travel times of a given metropolitan area. Our main focus is to estimate travel times along the arterial road segments where relevant data are often unavailable. The central idea of our approach is to leverage easy-to-obtain, aggregated data sets with broad spatial coverage, such as the data published by Uber Movement, as the fabric over which other expensive, fine-grained datasets, such as loop counter and probe data, can be overlaid. Our proposed methodology uses a graph representation of the road network and combines several techniques such as graph-based routing, trip sampling, graph sparsification, and least-squares optimization to estimate the street-level travel times. Using sampled trips and weighted shortest-path routing, we iteratively solve constrained least-squares problems to obtain the travel time estimates. We demonstrate our method on the Los Angeles metropolitan-area street network, where aggregated travel time data is available for trips between traffic analysis zones. Additionally, we present techniques to scale our approach via a novel graph pseudo-sparsification technique.

Fluence map optimization for intensity-modulated radiation therapy planning can be formulated as a large-scale inverse problem with competing objectives and constraints associated with the tumors and organs-at-risk. Unfortunately, clinically relevant dose-volume constraints are nonconvex, so standard algorithms for convex problems cannot be directly applied. While prior work focused on convex approximations for these constraints, we propose a novel relaxation approach to handle nonconvex dose-volume constraints. We develop efficient, provably convergent algorithms based on partial minimization, and show how to adapt them to handle maximum-dose constraints and infeasible problems. We demonstrate our approach using the CORT dataset, and show that it is easily adaptable to radiation treatment planning with dose-volume constraints for multiple tumors and organs-at-risk., Comment: 38 pages, 18 figures

There are several different modalities, e.g., surgery, chemotherapy, and radiotherapy, that are currently used to treat cancer. It is common practice to use a combination of these modalities to maximize clinical outcomes, which are often measured by a balance between maximizing tumor damage and minimizing normal tissue side effects due to treatment. However, multi-modality treatment policies are mostly empirical in current practice, and are therefore subject to individual clinicians' experiences and intuition. We present a novel formulation of optimal multi-modality cancer management using a finite-horizon Markov decision process approach. Specifically, at each decision epoch, the clinician chooses an optimal treatment modality based on the patient's observed state, which we define as a combination of tumor progression and normal tissue side effect. Treatment modalities are categorized as (1) Type 1, which has a high risk and high reward, but is restricted in the frequency of administration during a treatment course, (2) Type 2, which has a lower risk and lower reward than Type 1, but may be repeated without restriction, and (3) Type 3, no treatment (surveillance), which has the possibility of reducing normal tissue side effect at the risk of worsening tumor progression. Numerical simulations using various intuitive, concave reward functions show the structural insights of optimal policies and demonstrate the potential applications of using a rigorous approach to optimizing multi-modality cancer management., Comment: 15 pages, 11 figures