Together with researchers from Centrum voor Wiskunde & Informatica (CWI), Leiden University Medical Center (LUMC) and the company Elekta, Amsterdam UMC developed the software BRIGHT 2.0. From Amsterdam UMC, radiotherapist Bradley Pieters was involved from the beginning. “It is an improved version of the previous version of BRIGHT. The BRIGHT software efficiently calculates the best treatment options.”
Complex
The treatment plans in BRIGHT are for brachytherapy, or internal radiation therapy. When making these radiation treatment plans, there is always a trade-off between the highest possible dose of radioactive radiation on the tumor and the lowest possible dose on the surrounding healthy organs. The healthy organs should receive as little radioactive radiation as possible. Because of the complexity, it takes time to make these plans. Previously, it was regularly necessary to manually adjust the plans obtained with software. “Recently, we used the new software BRIGHT 2.0 for the first time in determining the treatment of 3 patients. The application proved impressive. The speed with which we were able to determine the best radiation treatment plan and the fact that no more manual adjustments were needed, I did not expect beforehand.”
The best plan
Whereas in the previous version of BRIGHT the planning team had to make manual adjustments and it took almost three quarters of an hour before an overview of possible treatment plans was available, now this can be done within fifteen minutes and without manual adjustments. Also, with the new software, the physician can very quickly review the proposed plans and select the best plan for just that one patient. Pieters explained that the new technology was created with so-called “Evolutionary Algorithms,” a form of artificial intelligence. Evolutionary Algorithms are ideally suited to finding multiple solutions at once that make different trade-offs between conflicting goals, such as a high dose of radioactive radiation on the tumor and low dose on the healthy organs.
How does brachytherapy work?
Brachytherapy is used in many hospitals, most commonly for cervical cancer. In this procedure, the doctor inserts several tubes near the tumor, in different positions. The tubes are hollow and can be loaded with a radioactive source. Sometimes there are 4 or 5 tubes, sometimes as many as 18. The radioactive source can deliver a dose at every millimeter in the tubes for a short or long time. “Because of the variety of times and positions, it is very complex to calculate how the right amount of radiation gets to the right places. This process was previously time-consuming and physicians often did not have a full understanding of what the best plan was for the patient. With BRIGHT 2.0, the best treatment plan is selected accurately and super-fast.”
Future expansions
Currently, Amsterdam UMC is deploying BRIGHT for prostate cancer, but it will not stop there. Pieters: “We are now working on expanding the software to other cancer types. In collaboration with LUMC and Centrum voor Wiskunde & Informatica (CWI), we have started a new project, supported by KWF Kankerbestrijding and Elekta, to deploy BRIGHT for the treatment of cervical cancer. “Our goal is to make the technology available to more hospitals so that many more patients can benefit from these advances,” concludes an elated Pieters.