A methodology for the constrained customization of coplanar beam orientations in radiotherapy treatment planning using an artificial neural network (ANN) has been developed. The geometry of the patients, with cancer of the prostate, was modelled by reducing the external contour, planning target volume (PTV) and organs at risk (OARs) to a set of cuboids. The coordinates and size of the cuboids were given to the ANN as inputs. A previously developed beam-orientation constrained-customization (BOCC) scheme employing a conventional computer algorithm was used to determine the customized beam orientations in a training set containing 45 patient datasets.

Twelve patient datasets not involved in the training of the artificial neural network were used to test whether the ANN was able to map the inputs to customized beam orientations. Improvements from the customized beam orientations were compared with standard treatment plans with fixed gantry angles and plans produced from the BOCC scheme. The ANN produced customized beam orientations within 5° of the BOCC scheme in 62.5% of cases. The average difference in the beam orientations produced by the ANN and the BOCC scheme was 7.7° (±1.7, 1 SD). Compared with the standard treatment plans, the BOCC scheme produced plans with an increase in the average tumour control probability (TCP) of 5.7% (±1.4, 1 SD) whilst the ANN generated plans increased the average TCP by 3.9% (±1.3, 1 SD). Both figures refer to the TCP at a fixed rectal normal tissue complication probability (NTCP) of 1%.

In conclusion, even using a very simple model for the geometry of the patient, an ANN was able to produce beam orientations that were similar to those produced by a conventional computer algorithm.