Artificial intelligence applications in brachytherapy: A literature review

PURPOSE: Artificial intelligence (AI) has the potential to simplify and optimize various steps of the brachytherapy workflow, and this literature review aims to provide an overview of the work done in this field. METHODS AND MATERIALS: We conducted a literature search in June 2022 on PubMed, Embase, and Cochrane for papers that proposed AI applications in brachytherapy. RESULTS: A total of 80 papers satisfied inclusion/exclusion criteria. These papers were catego-rized as follows: segmentation (24), registration and image processing (6), preplanning (13), dose prediction and treatment planning (11), applicator/catheter/needle reconstruction (16), and quality assurance (10). AI techniques ranged from classical models such as support vector machines and decision tree-based learning to newer techniques such as U-Net and deep reinforcement learn-ing, and were applied to facilitate small steps of a process (e.g., optimizing applicator selection) or even automate the entire step of the workflow (e.g., end-to-end preplanning). Many of these algorithms demonstrated human-level performance and offer significant improvements in speed. CONCLUSIONS: AI has potential to augment, automate, and/or accelerate many steps of the brachytherapy workflow. We recommend that future studies adhere to standard reporting guide -lines. We also stress the importance of using larger sample sizes and reporting results using clinically interpretable measures. & COPY; 2023 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.