Elizabeth Kidd | Search arXiv

arXiv2026

ALMo: Interactive Aim-Limit-Defined, Multi-Objective System for Personalized High-Dose-Rate Brachytherapy Treatment Planning and Visualization for Cervical Cancer

In complex clinical decision-making, clinicians must often track a variety of competing metrics defined by aim (ideal) and limit (strict) thresholds. Sifting through these high-dimensional tradeoffs to infer the optimal patient-specific strategy is cognitively demanding and historically prone to variability. In this paper, we address this challenge within the context of High-Dose-Rate (HDR) brachytherapy for cervical cancer, where planning requires strictly managing radiation hot spots while balancing tumor coverage against organ sparing. We present ALMo (Aim-Limit-defined Multi-Objective system), an interactive decision support system designed to infer and operationalize clinician intent. ALMo employs a novel optimization framework that minimizes manual input through automated parameter setup and enables flexible control over toxicity risks. Crucially, the system allows clinicians to navigate the Pareto surface of dosimetric tradeoffs by directly manipulating intuitive aim and limit values. In a retrospective evaluation of 25 clinical cases, ALMo generated treatment plans that consistently met or exceeded manual planning quality, with 65% of cases demonstrating dosimetric improvements. Furthermore, the system significantly enhanced efficiency, reducing average planning time to approximately 17 minutes, compared to the conventional 30-60 minutes. While validated in brachytherapy, ALMo demonstrates a generalized framework for streamlining interaction in multi-criteria clinical decision-making.

cs.LG↗

arXiv2024

Modeling Multi-Objective Tradeoffs with Monotonic Utility Functions

Countless science and engineering applications in multi-objective optimization (MOO) necessitate that decision-makers (DMs) select a Pareto-optimal (PO) solution which aligns with their preferences. Evaluating individual solutions is often expensive, and the high-dimensional trade-off space makes exhaustive exploration of the full Pareto frontier (PF) infeasible. We introduce a novel, principled two-step process for obtaining a compact set of PO points that aligns with user preferences, which are specified a priori as general monotonic utility functions (MFs). Our process (1) densely samples the user's region of interest on the PF, then (2) sparsifies the results into a small, diverse set for the DM. We instantiate this framework with soft-hard functions (SHFs), an intuitive class of MFs that operationalizes the common expert heuristic of imposing soft and hard bounds. We provide extensive empirical validation of our framework instantiated with SHFs on diverse domains, including brachytherapy, engineering design, and large language models. For brachytherapy, our approach returns a compact set of points with over 3% greater SHF-defined utility than the next best approach. Among the other domains, our approach consistently leads in utility, as a final compact set of just 5 points captures over 99% of the utility offered by the entire dense set.

cs.LG↗