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Purpose: To quickly and automatically propagate organ contours from pretreatment to fraction images in magnetic resonance (MR)-guided prostate external-beam radiotherapy., Methods: Five prostate cancer patients underwent 20 fractions of image-guided external-beam radiotherapy on a 1.5 T MR-Linac system. For each patient, a pretreatment T2-weighted three-dimensional (3D) MR imaging (MRI) scan was used to delineate the clinical target volume (CTV) contours. The same scan was repeated during each fraction, with the CTV contour being manually adapted if necessary. A convolutional neural network (CNN) was trained for combined image registration and contour propagation. The network estimated the propagated contour and a deformation field between the two input images. The training set consisted of a synthetically generated ground truth of randomly deformed images and prostate segmentations. We performed a leave-one-out cross-validation on the five patients and propagated the prostate segmentations from the pretreatment to the fraction scans. Three variants of the CNN, aimed at investigating supervision based on optimizing segmentation overlap, optimizing the registration, and a combination of the two were compared to results of the open-source deformable registration software package Elastix., Results: The neural networks trained on segmentation overlap or the combined objective achieved significantly better Hausdorff distances between predicted and ground truth contours than Elastix, at the much faster registration speed of 0.5 s. The CNN variant trained to optimize both the prostate overlap and deformation field, and the variant trained to only maximize the prostate overlap, produced the best propagation results., Conclusions: A CNN trained on maximizing prostate overlap and minimizing registration errors provides a fast and accurate method for deformable contour propagation for prostate MR-guided radiotherapy., (© 2019 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.)

Purpose: Local specific absorption rate (SAR) cannot be measured and is usually evaluated by offline numerical simulations using generic body models that of course will differ from the patient's anatomy. An additional safety margin is needed to include this intersubject variability. In this work, we present a deep learning-based method for image-based subject-specific local SAR assessment. We propose to train a convolutional neural network to learn a "surrogate SAR model" to map the relation between subject-specific B 1 + maps and the corresponding local SAR., Method: Our database of 23 subject-specific models with an 8-transmit channel body array for prostate imaging at 7 T was used to build 5750 training samples. These synthetic complex B 1 + maps and local SAR distributions were used to train a conditional generative adversarial network. Extra penalization for local SAR underestimation errors was included in the loss function. In silico and in vivo validation were performed., Results: In silico cross-validation shows a good qualitative and quantitative match between predicted and ground-truth local SAR distributions. The peak local SAR estimation error distribution shows a mean overestimation error of 15% with 13% probability of underestimation. The higher accuracy of the proposed method allows the use of less conservative safety factors compared with standard procedures. In vivo validation shows that the method is applicable with realistic measurement data with impressively good qualitative and quantitative agreement to simulations., Conclusion: The proposed deep learning method allows online image-based subject-specific local SAR assessment. It greatly reduces the uncertainty in current state-of-the-art SAR assessment methods, reducing the time in the examination protocol by almost 25%., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)