Respiratory motion forecasting with online learning of recurrent neural networks for safety enhancement in externally guided radiotherapy

In lung radiotherapy, infrared cameras can record the location of reflective objects on the chest to infer the position of the tumor moving due to breathing, but treatment system latencies hinder radiation beam precision. Real-time recurrent learning (RTRL), is a potential solution as it can learn patterns within non-stationary respiratory data but has high complexity. This study assesses the capabilities of resource-efficient online RNN algorithms, namely unbiased online recurrent optimization (UORO), sparse-1 step approximation (SnAp-1), and decoupled neural interfaces (DNI) to forecast respiratory motion during radiotherapy treatment accurately. We use time series containing the 3D position of external markers on the chest of healthy subjects. We propose efficient implementations for SnAp-1 and DNI based on compression of the influence and immediate Jacobian matrices and an accurate update of the linear coefficients used in credit assignment estimation, respectively. The original sampling frequency was 10Hz; we performed resampling at 3.33Hz and 30Hz. We use UORO, SnAp-1, and DNI to forecast each marker's 3D position with horizons (the time interval in advance for which the prediction is made) h<=2.1s and compare them with RTRL, least mean squares, and linear regression. RNNs trained online achieved similar or better accuracy than most previous works using larger training databases and deep learning, even though we used only the first minute of each sequence to predict motion within that exact sequence. SnAp-1 had the lowest normalized root mean square errors (nRMSE) averaged over the horizon values considered, equal to 0.335 and 0.157, at 3.33Hz and 10.0Hz, respectively. Similarly, UORO had the highest accuracy at 30Hz, with an nRMSE of 0.0897. DNI's inference time, equal to 6.8ms per time step at 30Hz (Intel Core i7-13700 CPU), was the lowest among the RNN methods examined.

Prediction of the motion of chest internal points using a recurrent neural network trained with real-time recurrent learning for latency compensation in lung cancer radiotherapy

During the radiotherapy treatment of patients with lung cancer, the radiation delivered to healthy tissue around the tumor needs to be minimized, which is difficult because of respiratory motion and the latency of linear accelerator systems. In the proposed study, we first use the Lucas-Kanade pyramidal optical flow algorithm to perform deformable image registration of chest computed tomography scan images of four patients with lung cancer. We then track three internal points close to the lung tumor based on the previously computed deformation field and predict their position with a recurrent neural network (RNN) trained using real-time recurrent learning (RTRL) and gradient clipping. The breathing data is quite regular, sampled at approximately 2.5Hz, and includes artificial drift in the spine direction. The amplitude of the motion of the tracked points ranged from 12.0mm to 22.7mm. Finally, we propose a simple method for recovering and predicting 3D tumor images from the tracked points and the initial tumor image based on a linear correspondence model and Nadaraya-Watson non-linear regression. The root-mean-square error, maximum error, and jitter corresponding to the RNN prediction on the test set were smaller than the same performance measures obtained with linear prediction and least mean squares (LMS). In particular, the maximum prediction error associated with the RNN, equal to 1.51mm, is respectively 16.1% and 5.0% lower than the maximum error associated with linear prediction and LMS. The average prediction time per time step with RTRL is equal to 119ms, which is less than the 400ms marker position sampling time. The tumor position in the predicted images appears visually correct, which is confirmed by the high mean cross-correlation between the original and predicted images, equal to 0.955.

Prediction of the Position of External Markers Using a Recurrent Neural Network Trained With Unbiased Online Recurrent Optimization for Safe Lung Cancer Radiotherapy

During lung cancer radiotherapy, the position of infrared reflective objects on the chest can be recorded to estimate the tumor location. However, radiotherapy systems usually have a latency inherent to robot control limitations that impedes the radiation delivery precision. Not taking this phenomenon into account may cause unwanted damage to healthy tissues and lead to side effects such as radiation pneumonitis. In this research, we use nine observation records of the three-dimensional position of three external markers on the chest and abdomen of healthy individuals breathing during intervals from 73s to 222s. The sampling frequency is equal to 10Hz and the amplitudes of the recorded trajectories range from 6mm to 40mm in the superior-inferior direction. We forecast the location of each marker simultaneously with a horizon value (the time interval in advance for which the prediction is made) between 0.1s and 2.0s, using a recurrent neural network (RNN) trained with unbiased online recurrent optimization (UORO). We compare its performance with an RNN trained with real-time recurrent learning, least mean squares (LMS), and offline linear regression. Training and cross-validation are performed during the first minute of each sequence. On average, UORO achieves the lowest root-mean-square (RMS) and maximum error, equal respectively to 1.3mm and 8.8mm, with a prediction time per time step lower than 2.8ms (Dell Intel core i9-9900K 3.60Ghz). Linear regression has the lowest RMS error for the horizon values 0.1s and 0.2s, followed by LMS for horizon values between 0.3s and 0.5s, and UORO for horizon values greater than 0.6s.