Automated Treatment Planning for Interstitial HDR Brachytherapy for Locally Advanced Cervical Cancer using Deep Reinforcement Learning

High-dose-rate (HDR) brachytherapy plays a critical role in the treatment of locally advanced cervical cancer but remains highly dependent on manual treatment planning expertise. The objective of this study is to develop a fully automated HDR brachytherapy planning framework that integrates reinforcement learning (RL) and dose-based optimization to generate clinically acceptable treatment plans with improved consistency and efficiency. We propose a hierarchical two-stage autoplanning framework. In the first stage, a deep Q-network (DQN)-based RL agent iteratively selects treatment planning parameters (TPPs), which control the trade-offs between target coverage and organ-at-risk (OAR) sparing. The agent's state representation includes both dose-volume histogram (DVH) metrics and current TPP values, while its reward function incorporates clinical dose objectives and safety constraints, including D90, V150, V200 for targets, and D2cc for all relevant OARs (bladder, rectum, sigmoid, small bowel, and large bowel). In the second stage, a customized Adam-based optimizer computes the corresponding dwell time distribution for the selected TPPs using a clinically informed loss function. The framework was evaluated on a cohort of patients with complex applicator geometries. The proposed framework successfully learned clinically meaningful TPP adjustments across diverse patient anatomies. For the unseen test patients, the RL-based automated planning method achieved an average score of 93.89%, outperforming the clinical plans which averaged 91.86%. These findings are notable given that score improvements were achieved while maintaining full target coverage and reducing CTV hot spots in most cases.

Patient-Specific Deep Reinforcement Learning for Automatic Replanning in Head-and-Neck Cancer Proton Therapy

Anatomical changes during intensity-modulated proton therapy (IMPT) for head-and-neck cancer (HNC) can shift Bragg peaks, risking tumor underdosing and organ-at-risk overdosing. As a result, treatment replanning is often required to maintain clinically acceptable treatment quality. However, current manual replanning processes are resource-intensive and time-consuming. We propose a patient-specific deep reinforcement learning (DRL) framework for automated IMPT replanning, with a reward-shaping mechanism based on a $150$-point plan quality score addressing competing clinical objectives. We formulate the planning process as an RL problem where agents learn control policies to adjust optimization priorities, maximizing plan quality. Unlike population-based approaches, our framework trains personalized agents for each patient using their planning CT (Computed Tomography) and augmented anatomies simulating anatomical changes (tumor progression and regression). This patient-specific approach leverages anatomical similarities throughout treatment, enabling effective plan adaptation. We implemented two DRL algorithms, Deep Q-Network and Proximal Policy Optimization, using dose-volume histograms (DVHs) as state representations and a $22$-dimensional action space of priority adjustments. Evaluation on five HNC patients using actual replanning CT data showed both DRL agents improved initial plan scores from $120.63 \pm 21.40$ to $139.78 \pm 6.84$ (DQN) and $142.74 \pm 5.16$ (PPO), surpassing manual replans generated by a human planner ($137.20 \pm 5.58$). Clinical validation confirms that improvements translate to better tumor coverage and OAR sparing across diverse anatomical changes. This work demonstrates DRL's potential in addressing geometric and dosimetric complexities of adaptive proton therapy, offering efficient offline adaptation solutions and advancing online adaptive proton therapy.

Learning Control Policies of Hodgkin-Huxley Neuronal Dynamics

We present a neural network approach for closed-loop deep brain stimulation (DBS). We cast the problem of finding an optimal neurostimulation strategy as a control problem. In this setting, control policies aim to optimize therapeutic outcomes by tailoring the parameters of a DBS system, typically via electrical stimulation, in real time based on the patient's ongoing neuronal activity. We approximate the value function offline using a neural network to enable generating controls (stimuli) in real time via the feedback form. The neuronal activity is characterized by a nonlinear, stiff system of differential equations as dictated by the Hodgkin-Huxley model. Our training process leverages the relationship between Pontryagin's maximum principle and Hamilton-Jacobi-Bellman equations to update the value function estimates simultaneously. Our numerical experiments illustrate the accuracy of our approach for out-of-distribution samples and the robustness to moderate shocks and disturbances in the system.

A SWAT-based Reinforcement Learning Framework for Crop Management

Crop management involves a series of critical, interdependent decisions or actions in a complex and highly uncertain environment, which exhibit distinct spatial and temporal variations. Managing resource inputs such as fertilizer and irrigation in the face of climate change, dwindling supply, and soaring prices is nothing short of a Herculean task. The ability of machine learning to efficiently interrogate complex, nonlinear, and high-dimensional datasets can revolutionize decision-making in agriculture. In this paper, we introduce a reinforcement learning (RL) environment that leverages the dynamics in the Soil and Water Assessment Tool (SWAT) and enables management practices to be assessed and evaluated on a watershed level. This drastically saves time and resources that would have been otherwise deployed during a full-growing season. We consider crop management as an optimization problem where the objective is to produce higher crop yield while minimizing the use of external farming inputs (specifically, fertilizer and irrigation amounts). The problem is naturally subject to environmental factors such as precipitation, solar radiation, temperature, and soil water content. We demonstrate the utility of our framework by developing and benchmarking various decision-making agents following management strategies informed by standard farming practices and state-of-the-art RL algorithms.

Forecasting Soil Moisture Using Domain Inspired Temporal Graph Convolution Neural Networks To Guide Sustainable Crop Management

Climate change, population growth, and water scarcity present unprecedented challenges for agriculture. This project aims to forecast soil moisture using domain knowledge and machine learning for crop management decisions that enable sustainable farming. Traditional methods for predicting hydrological response features require significant computational time and expertise. Recent work has implemented machine learning models as a tool for forecasting hydrological response features, but these models neglect a crucial component of traditional hydrological modeling that spatially close units can have vastly different hydrological responses. In traditional hydrological modeling, units with similar hydrological properties are grouped together and share model parameters regardless of their spatial proximity. Inspired by this domain knowledge, we have constructed a novel domain-inspired temporal graph convolution neural network. Our approach involves clustering units based on time-varying hydrological properties, constructing graph topologies for each cluster, and forecasting soil moisture using graph convolutions and a gated recurrent neural network. We have trained, validated, and tested our method on field-scale time series data consisting of approximately 99,000 hydrological response units spanning 40 years in a case study in northeastern United States. Comparison with existing models illustrates the effectiveness of using domain-inspired clustering with time series graph neural networks. The framework is being deployed as part of a pro bono social impact program. The trained models are being deployed on small-holding farms in central Texas.