Use of AI advances adaptive radiation therapy in cancer treatment

AMA News Wire

Use of AI advances adaptive radiation therapy in cancer treatment

April 22, 2024

Radiation therapy kills cancerous tissue and leaves healthy tissue intact. Save patients while minimizing the side effects of treatment. These are simple oncological goals, but their implementation can be difficult because the patient picture, and therefore the literal location of the anatomy, can change from day to day.

That's where technology, guided by augmented intelligence (AI) and overseen by Henry Ford Health physicians and other clinicians, can help ease the burden on patients and give them back precious time to live their lives. .

Radiation oncology is often at the forefront of implementing cutting-edge technology to improve patient experience and clinical operations. The radiation oncology team at Henry Ford West Bloomfield Hospital in suburban Detroit is doing just that with an adaptive radiation therapy program.

The Radiation Oncology Program recently introduced the Varian Ethos system, powered by HyperSight, an innovative platform that leverages advanced image processing powered by AI.

Henry Ford Health is a member of the AMA Health System Program, which provides enterprise solutions that provide leaders, physicians, and care teams with resources to advance the future of health care.

Use of the Ethos system has helped improve the accuracy and effectiveness of adaptive radiation therapy at Henry Ford West Bloomfield and has also improved the patient experience for people with certain cancers.

Here's how Henry Ford Health uses AI to improve adaptive radiation therapy for cancer patients.

Henry Ford Health uses the Ethos system to address one of the biggest challenges in radiation oncology: how to adjust radiation plans to accommodate the daily natural changes that occur in a patient's anatomy. has been introduced online.

For example, natural body functions such as bladder filling and digestion can cause changes in a patient's organs and tissues.

“When a patient comes in, their anatomy may be different today than it was yesterday or the day they first saw their radiation oncologist,” says Henry Ford Health's director of physics and academic radiologist. said Dr. Kundan Shinde, Deputy Chief of Oncology.

Because radiation is a highly targeted treatment, even small changes in patient anatomy can affect previously planned clinical protocol metrics. These protocols determine the radiation dose that cancerous tissue receives and the amount of dose savings needed to reduce risk to nearby healthy tissues and organs.

Any changes in the anatomy can shift the location of cancerous tissue. As a result, the cancer may receive less radiation than originally planned, and healthy tissues and organs may receive more radiation.

The new Ethos system has helped the radiation oncology team successfully address this issue by fine-tuning the program's adaptive radiation treatment process. The updated process combines the technology's image processing capabilities and AI-generated segmentation with clinician-driven oversight and decision-making.

“This system allows us to provide patients with radiotherapy treatments that can be adapted on a daily basis,” said Thind.

When a patient comes in for treatment, the Ethos system quickly creates high-quality cone-beam computed tomography images that visualize the patient's anatomy that day. Using these real-time images, AI solutions identify and segment organs, healthy tissue, and cancerous tissue. Next, calculate a new dose plan calculation for each patient.

“This is not just a step, but a giant leap forward in cancer treatment,” Ben Movsas, M.D., a radiation oncologist and chief and medical director of radiation oncology at Henry Ford Cancer Company, said in a news release. “This new system allows us to adjust and customize treatments in real time based on individual patient needs and anatomy, as well as specific changes observed during treatment. Masu.”

Armed with data, clinical teams can seamlessly recalibrate radiation doses and adapt treatment plans to comply with initial protocols. This provides a customized treatment approach for each patient, ensuring efficient and effective treatment that targets the cancer and spares surrounding healthy tissues and organs.

This technology plays an important role in the adaptive radiotherapy process, but the heavy lifting is done by doctors and other medical professionals.

At Henry Ford West Bloomfield Hospital, adaptive radiation oncology is a team effort. The team includes a radiation oncologist who leads the process, a radiation therapist who ensures the process runs smoothly and the patient is comfortable, and a medical physicist who oversees the technical aspects.

“Together, we came to a decision about whether and to what extent we should proceed with adaptive radiation therapy,” Shinde said. “The whole team has to be in front of the console and able to work together to make adaptive radiation therapy successful.”

This all-hands-on-deck approach requires additional resources, sophisticated workflows, clinical training, and, of course, the technology itself to successfully implement adaptive radiotherapy approaches.

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The combination of advanced imaging and efficient and accurate AI-powered data analysis has streamlined workflows and improved the quality and efficiency of care.

AI capabilities are particularly useful in managing some of the complexity of treatment by quickly performing the tasks necessary to ensure treatment success. This includes identifying and segmenting organs and ensuring that 3D dose variation is properly calculated. The doctor reviews and supervises her AI-driven output, and this technology has helped speed up these processes significantly.

But most importantly, the system has played a key role in improving the patient experience for radiation oncology patients at Henry Ford West Bloomfield Hospital.

Increased efficiency has resulted in shorter treatment times for patients and, in some cases, fewer radiation treatments. For a patient who comes in for treatment over a certain number of weeks, five days a week, even having one or two fewer appointments can make a difference.

Additionally, clinical teams have more time with patients and can focus more on quality of care. The overall adaptive treatment time was approximately 45 minutes, and patient satisfaction was high overall.

The AMA has developed advocacy principles based on its AI policy. These principles (PDF) address the development, implementation, and use of healthcare AI, with a particular focus on:

• Healthcare AI monitoring.
• When and what to disclose to increase AI transparency.
• Generative AI policy and governance.
• Physician responsibility for the use of AI-enabled technology.
• AI data privacy and cybersecurity.
• Use of AI and automated decision-making systems by payers.

Although there is ample evidence supporting the benefits of AI-assisted adaptive radiotherapy, this is still an emerging field. Specifically, researchers will study which cancers benefit most from adaptive radiation therapy compared to conventional radiation therapy, and how often treatments need to be adapted. doing.

“Adaptive radiation therapy clearly proves useful because it allows the dose to be precisely tailored to the patient's changing anatomy,” Thind said. “But there are still other questions that we are considering, such as how often to do it and what dose to choose. We are discussing these questions across the field.”

Currently, radiation oncologists at Henry Ford Health are using this system to treat cancers that, based on current evidence, benefit most from adaptive radiation therapy. These include prostate cancer, gastrointestinal cancer, and lung cancer.

Improved accuracy would be particularly useful in treating prostate cancer.

“It's really important to adapt the radiation plan to ensure that it not only targets the prostate, but also the high-risk cancer areas within the prostate,” says Shinde. “This system helps ensure that these zones are accurately and properly targeted.”

Researchers at Henry Ford Health are also currently studying how AI-powered adaptive radiation therapy could benefit patients with other cancers.

“Ultimately, we hope to treat all types of cancer for which adaptive radiation therapy has proven benefits over conventional radiation therapy,” Shinde said. “As more evidence emerges and we collect our own evidence using this technology, we plan to expand to other disease sites.”

Learn more about the emerging landscape of augmented intelligence in healthcare at AMA (PDF).