RADIANT: A fully configurable radiotherapy dose prediction framework

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Best configuration achieved dose score of 1.31 (training) and 1.20 (test) for cervical cancer

• Primary Outcome: Dose prediction accuracy measured by dose score and clinical dosimetric parameters

• Nnt Or Sensitivity: Sub-1% errors in D95 and D98 for cervical cancer dose predictions

• Confidence Interval: Not reported

Clinical Application

High feasibility given open-source nature and configurable framework, though requires technical expertise for implementation Relevant to Australian radiation oncology centres using modern treatment planning systems. Could support TGA-approved treatment planning workflows and align with RANZCR guidelines for quality assurance in radiotherapy Radiation oncology departments treating cervical, prostate, and head and neck cancers

Abstract

Objective.Treatment planning is a multi-disciplinary effort that requires medical decision-making, specialized training, and access to specialized software. Recently, deep learning has arisen as a powerful method for predicting patient-specific dose distributions. This work presents the radiotherapy dose inference and analysis toolkit (RADIANT), an open-source, fully configurable framework for 3D radiotherapy dose prediction. Built upon the Medical Imaging Segmentation Toolkit, RADIANT supports diverse network architectures, loss functions, and training strategies.Approach.We demonstrate its capabilities on cervical and prostate treatment plans generated with the radiation planning assistant, and on head and neck cancer plans from the American Association of Physicists in Medicine OpenKBP challenge data. For cervical cancer, we trained and compared nnU-Net, FMG-Net, W-Net, ddU-Net, and Swin UNETR using clinical metrics such as dose score, homogeneity index, and percent errors inD95,D98, andD99. Benchmarking was also performed on the OpenKBP dataset using dose score and dose-volume histogram (DVH) score for comparison with top challenge submissions.Results.Our results indicate that RADIANT provides a scalable platform for the rapid development and benchmarking of dose prediction models for selected cancer sites (cervix, prostate, head and neck). For cervical cancer, the best configuration (nnU-Net architecture, mean absolute error loss, cosine learning rate scheduler) achieved a dose score of 1.31 and sub-1%errors inD95andD98on the training set, and a dose score of 1.20 on the test set. The same configuration performed best on prostate data with a dose score of 1.96 on a test set. On the head and neck OpenKBP data, RADIANT achieved a dose score of 2.702 and a DVH score of 1.495, competitive with top challenge results.Significance.This work provides an open-source, fully configurable framework for deep learning-based dose prediction. RADIANT facilitates reproducible experimentation across data preprocessing, model configuration, training, and evaluation for multiple cancer sites and anatomical structures.

References

1. 1.Pafeng, J., Celaya, A., Gay, S., Fuentes, D., Martel, M., Court, L., & Netherton, T. (2026). RADIANT: A fully configurable radiotherapy dose prediction framework. Biomedical Physics & Engineering Express. https://doi.org/10.1088/2057-1976/ae7090