Clinical Trials Logo

Clinical Trial Summary

This project's goal is to develop and test an application that uses Artificial Intelligence (AI) to improve consistency and quality of Radiation Treatment (RT) plans for prostate cancer. By understanding expert planner preferences in structure contouring and treatment planning, and combining this framework with planning data and outcomes amassed in NRG clinical trials, AI models may be trained to produce contours and treatment plans that are indistinguishable or even potentially deemed superior to those produced by individual experts. At the conclusion of this contract, the awardees will provide a software product which, when given the input of a description of desired anatomical target volumes and target doses along with a patient's CT scans, will generate target volumes and radiation treatment plans based upon a "gold standard" amalgamated from the input of multiple experts, thereby achieving desired doses to target volumes while meeting or exceeding the dose-volume constraints imposed by adjacent normal tissues.


Clinical Trial Description

PHASE 1 1. Develop a process and tools (DAST) to capture the rationale, criteria, and logical basis behind the treatment planning process using well understood Human Factors knowledge gathering methodologies and Machine Learning tools. 2. Build the AI technology to learn the process and apply it to generating treatment plans. Images and expert-drawn volumes from Radiation Therapy Oncology Group (RTOG) 0938 will be used for initial training of the AI system. These data are not Dartmouth-Hitchcock Medical Center (DHMC) patients, but rather were consented and acquired through RTOG 0938. These data are housed at NRG/RTOG headquarters in Philadelphia. NRG already has an established, IRB-approved protocol for exploring AI systems for the 0938 data set. A minimum of 30 cases will be used for this initial training work for the AI system to "learn" volume segmentation of important structures and targets. Additional patients from the available 200+ patients on 0938 may be added for additional AI learning of volume segmentation as initial software programming is implemented. 3. Determine the optimal number of historic treatment plans to train the AI technology and test it. 45 cases will be provided by NRG from NRG/RTOG studies 0415, 0126, and 0521 (totaling 135 cases), respectively representing favorable-, intermediate-, and high-risk prostate cancer treatments. These scans and expert-defined volumes are part of NRG datasets housed in Philadelphia. All these patients already signed study-specific consents which included permissions to allow personally specific clinical information to be used for other cancer-related studies. IRB review of the use of these data for this specific study is anticipated to be achieved through NRG mechanisms in the context of these prior consents, to assure that the use of these data for this specific AI study is appropriate and approved. Provision is anticipated of a total of 30 additional patient cases as "gold standards," 10 each from DHMC, University of Massachusetts (UMass), and Oregon Health Sciences University (OHSU), respectively, all initially planned and treated within the 2015-2018 time frame. The first 5 from each institution will be favorable-risk patients, and the next 5 from each institution will be high-risk patients (thereby achieving a wide range of treatment approaches, with more to be added subsequently). As part of this effort, each individual institution will contact its own specific patients (5 favorable-risk, 5 high-risk) to obtain study-specific consent for the use of their data for this protocol. Once anonymized, these scans and plans will be shared across all three institutions. For each of these patients, the other two ("non-host") institutions will create their own volumes and plans. Using a modified Delphi approach, the three teams will then meet to generate an agreed-upon "composite" plan for each patient. Thus, in total there will be four treatment plans for each of these 30 patients, yielding 120 total plans that will serve as the "gold standard" for this AI project, and will be inputted for testing/validation to the AI system. PHASE 2 4. Expand the database to include intermediate-risk patients, 5 respectively from each institution, following the above procedures, to yield an additional 60 plans to serve as additional inputs for the AI system. 5. Validate and test the AI technology by inputting patient images and target delineations from historic case data and assessing whether the AI technology-generated plans are "consistent" with the final plans that were created by expert clinicians. 6. Test the technology with new patient case data and validate the plan with a team of expert clinicians. This will involve "modified Turing tests," as developed in NRG-RTOG studies exploring AI applications. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04441775
Study type Observational
Source Dartmouth-Hitchcock Medical Center
Contact
Status Completed
Phase
Start date June 22, 2020
Completion date March 4, 2022

See also
  Status Clinical Trial Phase
Recruiting NCT05613023 - A Trial of 5 Fraction Prostate SBRT Versus 5 Fraction Prostate and Pelvic Nodal SBRT Phase 3
Recruiting NCT05540392 - An Acupuncture Study for Prostate Cancer Survivors With Urinary Issues Phase 1/Phase 2
Recruiting NCT05156424 - A Comparison of Aerobic and Resistance Exercise to Counteract Treatment Side Effects in Men With Prostate Cancer Phase 1/Phase 2
Completed NCT03177759 - Living With Prostate Cancer (LPC)
Completed NCT01331083 - A Phase II Study of PX-866 in Patients With Recurrent or Metastatic Castration Resistant Prostate Cancer Phase 2
Recruiting NCT05540782 - A Study of Cognitive Health in Survivors of Prostate Cancer
Active, not recruiting NCT04742361 - Efficacy of [18F]PSMA-1007 PET/CT in Patients With Biochemial Recurrent Prostate Cancer Phase 3
Completed NCT04400656 - PROState Pathway Embedded Comparative Trial
Completed NCT02282644 - Individual Phenotype Analysis in Patients With Castration-Resistant Prostate Cancer With CellSearch® and Flow Cytometry N/A
Recruiting NCT06037954 - A Study of Mental Health Care in People With Cancer N/A
Recruiting NCT06305832 - Salvage Radiotherapy Combined With Androgen Deprivation Therapy (ADT) With or Without Rezvilutamide in the Treatment of Biochemical Recurrence After Radical Prostatectomy for Prostate Cancer Phase 2
Recruiting NCT05761093 - Patient and Physician Benefit/ Risk Preferences for Treatment of mPC in Hong Kong: a Discrete Choice Experiment
Completed NCT04838626 - Study of Diagnostic Performance of [18F]CTT1057 for PSMA-positive Tumors Detection Phase 2/Phase 3
Recruiting NCT03101176 - Multiparametric Ultrasound Imaging in Prostate Cancer N/A
Completed NCT03290417 - Correlative Analysis of the Genomics of Vitamin D and Omega-3 Fatty Acid Intake in Prostate Cancer N/A
Active, not recruiting NCT00341939 - Retrospective Analysis of a Drug-Metabolizing Genotype in Cancer Patients and Correlation With Pharmacokinetic and Pharmacodynamics Data
Completed NCT01497925 - Ph 1 Trial of ADI-PEG 20 Plus Docetaxel in Solid Tumors With Emphasis on Prostate Cancer and Non-Small Cell Lung Cancer Phase 1
Recruiting NCT03679819 - Single-center Trial for the Validation of High-resolution Transrectal Ultrasound (Exact Imaging Scanner ExactVu) for the Detection of Prostate Cancer
Completed NCT03554317 - COMbination of Bipolar Androgen Therapy and Nivolumab Phase 2
Completed NCT03271502 - Effect of Anesthesia on Optic Nerve Sheath Diameter in Patients Undergoing Robot-assisted Laparoscopic Prostatectomy N/A