Exploring Machine Learning Models for Physical Dose Calculation in Carbon Ion Therapy Using Heterogeneous Imaging Data -- A Proof of Concept Study

Background: Accurate and fast dose calculation is essential for optimizing carbon ion therapy. Existing machine learning (ML) models have been developed for other radiotherapy modalities. They use patient data with uniform CT imaging properties. Purpose: This study investigates the application of several ML models for physical dose calculation in carbon ion therapy and compares their ability to generalize to CT data with varying resolutions. Among the models examined is a Diffusion Model, which is tested for the first time for the calculation of physical dose distributions. Methods: A dataset was generated using publicly available CT images of the head and neck region. Monoenergetic carbon ion beams were simulated at various initial energies using Geant4 simulation software. A U-Net architecture was developed for dose prediction based on distributions of material density in patients and of absorbed dose in water. It was trained as a Generative Adversarial Network (GAN) generator, a Diffusion Model noise estimator, and as a standalone network. Their performances were compared with two models from literature. Results: All models produced dose distributions deviating by less than 2% from that obtained by a full Monte Carlo simulation, even for a patient not seen during training. Dose calculation time on a GPU was in the range of 3 ms to 15 s. The resource-efficient U-Net appears to perform comparably to the more computationally intensive GAN and Diffusion Model. Conclusion: This study demonstrates that ML models can effectively balance accuracy and speed for physical dose calculation in carbon ion therapy. Using the computationally efficient U-Net can help conserve resources. The generalizability of the models to different CT image resolutions enables the use for different patients without extensive retraining.