MD-Dose: A Diffusion Model based on the Mamba for Radiotherapy Dose Prediction

Radiation therapy is crucial in cancer treatment. Experienced experts typically iteratively generate high-quality dose distribution maps, forming the basis for excellent radiation therapy plans. Therefore, automated prediction of dose distribution maps is significant in expediting the treatment process and providing a better starting point for developing radiation therapy plans. With the remarkable results of diffusion models in predicting high-frequency regions of dose distribution maps, dose prediction methods based on diffusion models have been extensively studied. However, existing methods mainly utilize CNNs or Transformers as denoising networks. CNNs lack the capture of global receptive fields, resulting in suboptimal prediction performance. Transformers excel in global modeling but face quadratic complexity with image size, resulting in significant computational overhead. To tackle these challenges, we introduce a novel diffusion model, MD-Dose, based on the Mamba architecture for predicting radiation therapy dose distribution in thoracic cancer patients. In the forward process, MD-Dose adds Gaussian noise to dose distribution maps to obtain pure noise images. In the backward process, MD-Dose utilizes a noise predictor based on the Mamba to predict the noise, ultimately outputting the dose distribution maps. Furthermore, We develop a Mamba encoder to extract structural information and integrate it into the noise predictor for localizing dose regions in the planning target volume (PTV) and organs at risk (OARs). Through extensive experiments on a dataset of 300 thoracic tumor patients, we showcase the superiority of MD-Dose in various metrics and time consumption.

SP-DiffDose: A Conditional Diffusion Model for Radiation Dose Prediction Based on Multi-Scale Fusion of Anatomical Structures, Guided by SwinTransformer and Projector

Radiation therapy serves as an effective and standard method for cancer treatment. Excellent radiation therapy plans always rely on high-quality dose distribution maps obtained through repeated trial and error by experienced experts. However, due to individual differences and complex clinical situations, even seasoned expert teams may need help to achieve the best treatment plan every time quickly. Many automatic dose distribution prediction methods have been proposed recently to accelerate the radiation therapy planning process and have achieved good results. However, these results suffer from over-smoothing issues, with the obtained dose distribution maps needing more high-frequency details, limiting their clinical application. To address these limitations, we propose a dose prediction diffusion model based on SwinTransformer and a projector, SP-DiffDose. To capture the direct correlation between anatomical structure and dose distribution maps, SP-DiffDose uses a structural encoder to extract features from anatomical images, then employs a conditional diffusion process to blend noise and anatomical images at multiple scales and gradually map them to dose distribution maps. To enhance the dose prediction distribution for organs at risk, SP-DiffDose utilizes SwinTransformer in the deeper layers of the network to capture features at different scales in the image. To learn good representations from the fused features, SP-DiffDose passes the fused features through a designed projector, improving dose prediction accuracy. Finally, we evaluate SP-DiffDose on an internal dataset. The results show that SP-DiffDose outperforms existing methods on multiple evaluation metrics, demonstrating the superiority and generalizability of our method.

Energy-Guided Diffusion Model for CBCT-to-CT Synthesis

Cone Beam CT (CBCT) plays a crucial role in Adaptive Radiation Therapy (ART) by accurately providing radiation treatment when organ anatomy changes occur. However, CBCT images suffer from scatter noise and artifacts, making relying solely on CBCT for precise dose calculation and accurate tissue localization challenging. Therefore, there is a need to improve CBCT image quality and Hounsfield Unit (HU) accuracy while preserving anatomical structures. To enhance the role and application value of CBCT in ART, we propose an energy-guided diffusion model (EGDiff) and conduct experiments on a chest tumor dataset to generate synthetic CT (sCT) from CBCT. The experimental results demonstrate impressive performance with an average absolute error of 26.87$\pm$6.14 HU, a structural similarity index measurement of 0.850$\pm$0.03, a peak signal-to-noise ratio of the sCT of 19.83$\pm$1.39 dB, and a normalized cross-correlation of the sCT of 0.874$\pm$0.04. These results indicate that our method outperforms state-of-the-art unsupervised synthesis methods in accuracy and visual quality, producing superior sCT images.