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Edition 10 - Humans and AI: Transforming Radiotherapy and Beyond
Discover daily adaptive proton therapy, MRI-Linac innovations for tumor monitoring, and the growing impact of AI-human collaboration in healthcare.
When combinations of humans and AI are useful
Daily adaptive proton therapy employed in the clinic for the first time
MRI-linac keeps track of brain tumour changes during radiotherapy
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Specialty: All // Sub-Specialty: AI // Body Site: All
1. When combinations of humans and AI are useful
A meta-study from MIT researchers looked at over 100 experiments of humans and AI working both separately, and together, to accomplish tasks. They found that some tasks benefited a lots of human-AI teamwork, while others got worse from the pairing. For tasks where humans working alone do worse than AI, the study found that putting humans in the loop to make final decisions actually delivers worse results. The study found that common design patterns like AI explanations and confidence scores showed no significant impact on performance for human-AI collaborative systems. It was found that human-AI collaboration was most effective for open-ended creative and generative tasks—but worse at decision-making tasks to choose between defined options. For those decision-making tasks, either humans or AI did better working alone.
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Paul’s Thoughts:
What this study shows is that adding a human in the loop does not always make the result better. Additionally, transparency doesn't always lead to the best human judgement - perhaps humans are not used to assessing these explanations and confidence scores? And finally human-machine collaboration seems to be successful for creative and generative tasks, while humans and AI may handle decision-making tasks better alone.
Timescale: Mid | 2 Years
Specialty: Radiotherapy // Sub-Specialty: Adaptation // Body Site: Brain
2. Daily adaptive proton therapy employed in the clinic for the first time
Physicists at the Paul Scherrer Institute have delivered daily adaptive proton therapy for the first time in the clinic. For five adults with tumours in the rigid body region (brain, skull base), the final few fractions of the patient's treatment were treated with the option to deliver an online adapted treatment plan. A total of 26 fractions were assessed for online adaptation, with the online adapted plan selected in 22 of the cases. In 92% of the fractions there were improved metrics to targets and OARs.
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Paul’s Thoughts:
A landmark study to see daily online adaptation, something that is commonplace in photon-based radiotherapy, being applied to proton therapy. Proton therapy benefits from a well-defined Bragg peak range that enables highly targeted dose delivery to a tumour while minimising dose to nearby healthy tissues. However, this precision also makes proton delivery extremely sensitive to anatomical changes along the beam path, and as such daily online adaptation has a potentially bigger impact in proton therapy than standard radiotherapy. Impressively, the authors said they could keep the treatment fraction to an average of 23 mins per fraction, which is only a slight increase on the standard time for delivery. It will be interesting to see this extended to anatomical sites that experience greater anatomical changes, where the impact of daily online adaptive will be greater.
Timescale: Mid | 4 Years
Specialty: Radiotherapy // Sub-Specialty: Prognosis // Body Site: Brain
3. MRI-linac keeps track of brain tumour changes during radiotherapy
The University of Miami studied 36 patients with glioblastoma radiotherapy on a MRI-Linac. Daily images were acquired over the course on 30 fractions, rather than the usual scheme of pre- and post-treatment. Changes in lesion volume were found for 60% of the cases.
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Paul’s Thoughts:
This is an important study that shows the potential need for daily adaptation in brain lesions. In the Plunkett paper from 2019 (doi: 10.1016/j.jocn.2019.07.019), it was demonstrated that it is important to treat brain metastases in a timely fashion, as the size of the lesion can grow significantly between diagnosis and treatment: more than 75% of tumours demonstrated growth and some grew more than 500%. This study from Cullison et al shows that brain tumours continue to grow during treatment.
Timescale: Mid | 2 Years
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