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DOE OSTI2015

MO-F-CAMPUS-T-04: Development and Evaluation of a Knowledge-Based Model for Treatment Planning of Lung Cancer Patients Using Stereotactic Body Radiotherapy (SBRT)

Purpose: To describe the development of a knowledge-based treatment planning model for lung cancer patients treated with SBRT, and to evaluate the model performance and applicability to different planning techniques and tumor locations. Methods: 105 lung SBRT plans previously treated at our institution were included in the development of the model using Varian’s RapidPlan DVH estimation algorithm. The model was trained with a combination of IMRT, VMAT, and 3D–CRT techniques. Tumor locations encompassed lesions located centrally vs peripherally (43:62), upper vs lower (62:43), and anterior vs posterior lobes (60:45). The model performance was validated with 25 cases independent of the training set, for both IMRT and VMAT. Model generated plans were created with only one optimization and no planner intervention. The original, general model was also divided into four separate models according to tumor location. The model was also applied using different beam templates to further improve workflow. Dose differences to targets and organs-at-risk were evaluated. Results: IMRT and VMAT RapidPlan generated plans were comparable to clinical plans with respect to target coverage and several OARs. Spinal cord dose was lowered in the model-based plans by 1Gy compared to the clinical plans, p=0.008. Splitting the model according to tumor location resulted in insignificant differences in DVH estimation. The peripheral model decreased esophagus dose to the central lesions by 0.5Gy compared to the original model, p=0.025, and the posterior model increased dose to the spinal cord by 1Gy compared to the anterior model, p=0.001. All template beam plans met OAR criteria, with 1Gy increases noted in maximum heart dose for the 9-field plans, p=0.04. Conclusion: A RapidPlan knowledge-based model for lung SBRT produces comparable results to clinical plans, with increased consistency and greater efficiency. The model encompasses both IMRT and VMAT techniques, differing tumor locations, and beam arrangements. Research supported in part by a grant from Varian Medical Systems, Palo Alto CA.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

Effect of Dosimetric Outliers on the Performance of a Commercial Knowledge-Based Planning Solution

Purpose: RapidPlan, a commercial knowledge-based planning solution, uses a model library containing the geometry and associated dosimetry of existing plans. This model predicts achievable dosimetry for prospective patients that can be used to guide plan optimization. However, it is unknown how suboptimal model plans (outliers) influence the predictions or resulting plans. We investigated the effect of, first, removing outliers from the model (cleaning it) and subsequently adding deliberate dosimetric outliers. Methods and Materials: Clinical plans from 70 head and neck cancer patients comprised the uncleaned (UC) Model{sub UC}, from which outliers were cleaned (C) to create Model{sub C}. The last 5 to 40 patients of Model{sub C} were replanned with no attempt to spare the salivary glands. These substantial dosimetric outliers were reintroduced to the model in increments of 5, creating Model{sub 5} to Model{sub 40} (Model{sub 5-40}). These models were used to create plans for a 10-patient evaluation group. Plans from Model{sub UC} and Model{sub C}, and Model{sub C} and Model{sub 5-40} were compared on the basis of boost (B) and elective (E) target volume homogeneity indexes (HI{sub B}/HI{sub E}) and mean doses to oral cavity, composite salivary glands (comp{sub sal}) and swallowing (comp{sub swal}) structures. Results: On average, outlier removal (Model{sub C} vs Model{sub UC}) had minimal effects on HI{sub B}/HI{sub E} (0%-0.4%) and sparing of organs at risk (mean dose difference to oral cavity and comp{sub sal}/comp{sub swal} were ≤0.4 Gy). Model{sub 5-10} marginally improved comp{sub sal} sparing, whereas adding a larger number of outliers (Model{sub 20-40}) led to deteriorations in comp{sub sal} up to 3.9 Gy, on average. These increases are modest compared to the 14.9 Gy dose increases in the added outlier plans, due to the placement of optimization objectives below the inferior boundary of the dose-volume histogram-predicted range. Conclusions: Overall, dosimetric outlier removal from or addition of 5 to 10 outliers to a 70-patient model had marginal effects on resulting plan quality. Although the addition of >20 outliers deteriorated plan quality, the effect was modest. In this study, RapidPlan demonstrated robustness for moderate proportions of salivary gland dosimetric outliers.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

NASA NTRS1993

Irrelevance Reasoning in Knowledge Based Systems

This dissertation considers the problem of reasoning about irrelevance of knowledge in a principled and efficient manner. Specifically, it is concerned with two key problems: (1) developing algorithms for automatically deciding what parts of a knowledge base are irrelevant to a query and (2) the utility of relevance reasoning. The dissertation describes a novel tool, the query-tree, for reasoning about irrelevance. Based on the query-tree, we develop several algorithms for deciding what formulas are irrelevant to a query. Our general framework sheds new light on the problem of detecting independence of queries from updates. We present new results that significantly extend previous work in this area. The framework also provides a setting in which to investigate the connection between the notion of irrelevance and the creation of abstractions. We propose a new approach to research on reasoning with abstractions, in which we investigate the properties of an abstraction by considering the irrelevance claims on which it is based. We demonstrate the potential of the approach for the cases of abstraction of predicates and projection of predicate arguments. Finally, we describe an application of relevance reasoning to the domain of modeling physical devices.

INFERENCE↗

NASA NTRS1991

Feasibility of using a knowledge-based system concept for in-flight primary-flight-display research

Flight test results have been obtained which demonstrate the feasibility and desirability of using knowledge-based systems architectures for flight test investigations of primary flight display information management-related issues. LISP-based software was used for real-time operation of the primary flight display. The two integrated knowledge-based systems designed to control the primary flight displays were implemented aboard a NASA-Langley B-737. The programmer is noted to be capable of more easily developing initial systems via the present method than with more conventional techniques.

Ricks, Wendell R.↗

DOE OSTI2015

Knowledge-based prediction of plan quality metrics in intracranial stereotactic radiosurgery

Purpose: The objective of this work was to develop a comprehensive knowledge-based methodology for predicting achievable dose–volume histograms (DVHs) and highly precise DVH-based quality metrics (QMs) in stereotactic radiosurgery/radiotherapy (SRS/SRT) plans. Accurate QM estimation can identify suboptimal treatment plans and provide target optimization objectives to standardize and improve treatment planning. Methods: Correlating observed dose as it relates to the geometric relationship of organs-at-risk (OARs) to planning target volumes (PTVs) yields mathematical models to predict achievable DVHs. In SRS, DVH-based QMs such as brain V{sub 10Gy} (volume receiving 10 Gy or more), gradient measure (GM), and conformity index (CI) are used to evaluate plan quality. This study encompasses 223 linear accelerator-based SRS/SRT treatment plans (SRS plans) using volumetric-modulated arc therapy (VMAT), representing 95% of the institution’s VMAT radiosurgery load from the past four and a half years. Unfiltered models that use all available plans for the model training were built for each category with a stratification scheme based on target and OAR characteristics determined emergently through initial modeling process. Model predictive accuracy is measured by the mean and standard deviation of the difference between clinical and predicted QMs, δQM = QM{sub clin} − QM{sub pred}, and a coefficient of determination, R{sup 2}. For categories with a large number of plans, refined models are constructed by automatic elimination of suspected suboptimal plans from the training set. Using the refined model as a presumed achievable standard, potentially suboptimal plans are identified. Predictions of QM improvement are validated via standardized replanning of 20 suspected suboptimal plans based on dosimetric predictions. The significance of the QM improvement is evaluated using the Wilcoxon signed rank test. Results: The most accurate predictions are obtained when plans are stratified based on proximity to OARs and their PTV volume sizes. Volumes are categorized into small (V{sub PTV} < 2 cm{sup 3}), medium (2 cm{sup 3} < V{sub PTV} < 25 cm{sup 3}), and large (25 cm{sup 3} < V{sub PTV}). The unfiltered models demonstrate the ability to predict GMs to ∼1 mm and fractional brain V{sub 10Gy} to ∼25% for plans with large V{sub PTV} and critical OAR involvements. Increased accuracy and precision of QM predictions are obtained when high quality plans are selected for the model training. For the small and medium V{sub PTV} plans without critical OAR involvement, predictive ability was evaluated using the refined model. For training plans, the model predicted GM to an accuracy of 0.2 ± 0.3 mm and fractional brain V{sub 10Gy} to 0.04 ± 0.12, suggesting highly accurate predictive ability. For excluded plans, the average δGM was 1.1 mm and fractional brain V{sub 10Gy} was 0.20. These δQM are significantly greater than those of the model training plans (p < 0.001). For CI, predictions are close to clinical values and no significant difference was observed between the training and excluded plans (p = 0.19). Twenty outliers with δGM > 1.35 mm were identified as potentially suboptimal, and replanning these cases using predicted target objectives demonstrates significant improvements on QMs: on average, 1.1 mm reduction in GM (p < 0.001) and 23% reduction in brain V{sub 10Gy} (p < 0.001). After replanning, the difference of δGM distribution between the 20 replans and the refined model training plans was marginal. Conclusions: The results demonstrate the ability to predict SRS QMs precisely and to identify suboptimal plans. Furthermore, the knowledge-based DVH predictions were directly used as target optimization objectives and allowed a standardized planning process that bettered the clinically approved plans. Full clinical application of this methodology can improve consistency of SRS plan quality in a wide range of PTV volume and proximity to OARs and facilitate automated treatment planning for this critical treatment site.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

MO-G-201-01: A Multi-Institutional Study Investigating the Performance of a Knowledge-Based Planning System Against Pinnacle Auto-Planning Engine in SIB-IMRT for the Head-And-Neck Cancer

Purpose: Knowledge-based Planning (KBP) founded on prior planning experience and Auto-Planning Engine (APE; commercialized in Pinnacle v9.10 TPS) based on progressive optimization algorithm both aim to eliminate the trial-and-error process in radiotherapy inverse planning. This study investigates the performance of the approaches in a multi-institutional setting to evaluate their functionalities in oropharyngeal cancer and offers suggestions how they can be implemented in the clinic. Methods: Radboud University Medical Center (RUMC) provided 35 oropharyngeal cancer patients (SIB-IMRT with two-dose-level prescription: 68 Gy to PTV68 and 50.3 Gy to PTV50.3) with corresponding comparative APE plans. Johns Hopkins University (JHU) contributed to a three-dose-level (70 Gy 63 Gy and 58.1 Gy) plan library for RUMC’s patient KBP generation. MedStar Georgetown University Hospital (MGUH) contributed to a KBP approach employing overlap-volume histogram (OVH-KBP) for generating RUMC’s patient KBP plans using JHU’s plan library. Since both approaches need their own user-defined parameters as initial inputs the first 10 patients were set aside as training set to finalize them. Meanwhile cross-institutional comparisons and adjustments were implemented for investigating institutions’ protocol discrepancies and the approaches’ user-defined parameters were updated accordingly. The finalized parameters were then applied to the remaining 25 patients for OVH-KBP and APE generation. A Wilcoxon rank-sum test was used for statistical comparison with significance level of p<0.05. Results: On average PTV68’s V95 was 96.5% in APE plans vs. 97% in OVH-KBP plans (p=0.36); PTV50.3’s V95 in APE plans was 97.8% vs.97.6% in OVH-KBP plans (p=0.6); cord’s D0.1 cc was 38.6 Gy in OVH-KBP plans vs. 43.7 Gy in APE plans (p=0.0001); mean doses to larynxes oral cavities parotids and submandibular glands were similar with p>0.2. Conclusions: The study demonstrates that KBP and APE can generate plans of comparable quality in a multi-institutional setting. Variations in clinical protocols can be effectively addressed for cross-institutional adaptations. Binbin Wu and Todd McNutt are the co-inventors of a patent associated with the proposed knowledge-based planning system which was licensed to Varian Medical Systems in 2015; This research was in part supported by Philips Radiation Oncology Systems.

60 APPLIED LIFE SCIENCES↗

NASA NTRS1991

A NASA/RAE cooperation in the development of a real-time knowledge based autopilot

As part of a US/UK cooperative aeronautical research program, a joint activity between NASA-Ames and the Royal Aerospace Establishment on Knowledge Based Systems (KBS) was established. This joint activity is concerned with tools and techniques for the implementation and validation of real-time KBS. The proposed next stage of the research is described, in which some of the problems of implementing and validating a Knowledge Based Autopilot (KBAP) for a generic high performance aircraft will be studied.

Daysh, Colin↗

NASA NTRS1988

Knowledge-based flow field zoning

Automation flow field zoning in two dimensions is an important step towards easing the three-dimensional grid generation bottleneck in computational fluid dynamics. A knowledge based approach works well, but certain aspects of flow field zoning make the use of such an approach challenging. A knowledge based flow field zoner, called EZGrid, was implemented and tested on representative two-dimensional aerodynamic configurations. Results are shown which illustrate the way in which EZGrid incorporates the effects of physics, shape description, position, and user bias in a flow field zoning.

Andrews, Alison E.↗

NASA NTRS1988

Knowledge-based flow field zoning

Andrews, Alison E.↗

NASA NTRS1991

Knowledge-based Autonomous Test Engineer (KATE)

Mathematical models of system components have long been used to allow simulators to predict system behavior to various stimuli. Recent efforts to monitor, diagnose, and control real-time systems using component models have experienced similar success. NASA Kennedy is continuing the development of a tool for implementing real-time knowledge-based diagnostic and control systems called KATE (Knowledge based Autonomous Test Engineer). KATE is a model-based reasoning shell designed to provide autonomous control, monitoring, fault detection, and diagnostics for complex engineering systems by applying its reasoning techniques to an exchangeable quantitative model describing the structure and function of the various system components and their systemic behavior.

Parrish, Carrie L.↗

DOE OSTI2023

Improving Knowledge Base with Network Architecture Diagrams

In order to ensure Cyber Security Team (CST) has access to updated and in-depth information regarding Fermilab systems, capabilities, procedures, tools, and training, the CST created the Knowledge Base. This consists of a wealth of information for current and future CST employees to improve knowledge retention and transfer. The Knowledge Base, however, uses outdated network diagrams that lack many of the previous and upcoming changes to the architecture. For this reason, updated diagrams have been created to reflect the current position of the CST capabilities. By employing the knowledge learned at Fermi National Accelerator Laboratory, three diagrams have been created to highlight the current state of the CST’s operations and capabilities.

Blum, Ethan↗

NASA NTRS1989

An American knowledge base in England - Alternate implementations of an expert system flight status monitor

A joint activity between the Dryden Flight Research Facility of the NASA Ames Research Center (Ames-Dryden) and the Royal Aerospace Establishment (RAE) on knowledge-based systems has been agreed. Under the agreement, a flight status monitor knowledge base developed at Ames-Dryden has been implemented using the real-time AI (artificial intelligence) toolkit MUSE, which was developed in the UK. Here, the background to the cooperation is described and the details of the flight status monitor and a prototype MUSE implementation are presented. It is noted that the capabilities of the expert-system flight status monitor to monitor data downlinked from the flight test aircraft and to generate information on the state and health of the system for the test engineers provides increased safety during flight testing of new systems. Furthermore, the expert-system flight status monitor provides the systems engineers with ready access to the large amount of information required to describe a complex aircraft system.

Butler, G. F.↗

DOE OSTI2017

Predicting Patient-specific Dosimetric Benefits of Proton Therapy for Skull-base Tumors Using a Geometric Knowledge-based Method

Purpose: To predict the organ at risk (OAR) dose levels achievable with proton beam therapy (PBT), solely based on the geometric arrangement of the target volume in relation to the OARs. A comparison with an alternative therapy yields a prediction of the patient-specific benefits offered by PBT. This could enable physicians at hospitals without proton capabilities to make a better-informed referral decision or aid patient selection in model-based clinical trials. Methods and Materials: Skull-base tumors were chosen to test the method, owing to their geometric complexity and multitude of nearby OARs. By exploiting the correlations between the dose and distance-to-target in existing PBT plans, the models were independently trained for 6 types of OARs: brainstem, cochlea, optic chiasm, optic nerve, parotid gland, and spinal cord. Once trained, the models could estimate the feasible dose–volume histogram and generalized equivalent uniform dose (gEUD) for OAR structures of new patients. The models were trained using 20 patients and validated using an additional 21 patients. Validation was achieved by comparing the predicted gEUD to that of the actual PBT plan. Results: The predicted and planned gEUD were in good agreement. Considering all OARs, the prediction error was +1.4 ± 5.1 Gy (mean ± standard deviation), and Pearson's correlation coefficient was 93%. By comparing with an intensity modulated photon treatment plan, the model could classify whether an OAR structure would experience a gain, with a sensitivity of 93% (95% confidence interval: 87%-97%) and specificity of 63% (95% confidence interval: 38%-84%). Conclusions: We trained and validated models that could quickly and accurately predict the patient-specific benefits of PBT for skull-base tumors. Similar models could be developed for other tumor sites. Such models will be useful when an estimation of the feasible benefits of PBT is desired but the experience and/or resources required for treatment planning are unavailable.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

NASA NTRS1992

Constraint-based component-modeling for knowledge-based design

The paper describes the application of various advanced programming techniques derived from artificial intelligence research to the development of flexible design tools for conceptual design. Special attention is given to two techniques which appear to be readily applicable to such design tools: the constraint propagation technique and the object-oriented programming. The implementation of these techniques in a prototype computer tool, Rubber Airplane, is described.

Kolb, Mark A.↗

NASA NTRS1985

A knowledge based software engineering environment testbed

The Carnegie Group Incorporated and Boeing Computer Services Company are developing a testbed which will provide a framework for integrating conventional software engineering tools with Artifical Intelligence (AI) tools to promote automation and productivity. The emphasis is on the transfer of AI technology to the software development process. Experiments relate to AI issues such as scaling up, inference, and knowledge representation. In its first year, the project has created a model of software development by representing software activities; developed a module representation formalism to specify the behavior and structure of software objects; integrated the model with the formalism to identify shared representation and inheritance mechanisms; demonstrated object programming by writing procedures and applying them to software objects; used data-directed and goal-directed reasoning to, respectively, infer the cause of bugs and evaluate the appropriateness of a configuration; and demonstrated knowledge-based graphics. Future plans include introduction of knowledge-based systems for rapid prototyping or rescheduling; natural language interfaces; blackboard architecture; and distributed processing

Gill, C.↗

NASA NTRS1989

Development of an intelligent interface for adding spatial objects to a knowledge-based geographic information system

Earth Scientists lack adequate tools for quantifying complex relationships between existing data layers and studying and modeling the dynamic interactions of these data layers. There is a need for an earth systems tool to manipulate multi-layered, heterogeneous data sets that are spatially indexed, such as sensor imagery and maps, easily and intelligently in a single system. The system can access and manipulate data from multiple sensor sources, maps, and from a learned object hierarchy using an advanced knowledge-based geographical information system. A prototype Knowledge-Based Geographic Information System (KBGIS) was recently constructed. Many of the system internals are well developed, but the system lacks an adequate user interface. A methodology is described for developing an intelligent user interface and extending KBGIS to interconnect with existing NASA systems, such as imagery from the Land Analysis System (LAS), atmospheric data in Common Data Format (CDF), and visualization of complex data with the National Space Science Data Center Graphics System. This would allow NASA to quickly explore the utility of such a system, given the ability to transfer data in and out of KBGIS easily. The use and maintenance of the object hierarchies as polymorphic data types brings, to data management, a while new set of problems and issues, few of which have been explored above the prototype level.

Campbell, William J.↗

NASA NTRS1994

Delivering spacecraft control centers with embedded knowledge-based systems: The methodology issue

Matra Marconi Space (MMS) occupies a leading place in Europe in the domain of satellite and space data processing systems. The maturity of the knowledge-based systems (KBS) technology, the theoretical and practical experience acquired in the development of prototype, pre-operational and operational applications, make it possible today to consider the wide operational deployment of KBS's in space applications. In this perspective, MMS has to prepare the introduction of the new methods and support tools that will form the basis of the development of such systems. This paper introduces elements of the MMS methodology initiatives in the domain and the main rationale that motivated the approach. These initiatives develop along two main axes: knowledge engineering methods and tools, and a hybrid method approach for coexisting knowledge-based and conventional developments.

Ayache, S.↗

DOE OSTI2015

WE-F-BRB-00: New Developments in Knowledge-Based Treatment Planning and Automation

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

60 APPLIED LIFE SCIENCES↗