#### Deep Learning 3D Dose Prediction for Conventional Lung IMRT Using Consistent/Unbiased Automated Plans

Deep learning (DL) 3D dose prediction has recently gained a lot of attention. However, the variability of plan quality in the training dataset, generated manually by planners with wide range of expertise, can dramatically effect the quality of the final predictions. Moreover, any changes in the clinical criteria requires a new set of manually generated plans by planners to build a new prediction model. In this work, we instead use consistent plans generated by our in-house automated planning system (named ECHO'') to train the DL model. ECHO (expedited constrained hierarchical optimization) generates consistent/unbiased plans by solving large-scale constrained optimization problems sequentially. If the clinical criteria changes, a new training data set can be easily generated offline using ECHO, with no or limited human intervention, making the DL-based prediction model easily adaptable to the changes in the clinical practice. We used 120 conventional lung patients (100 for training, 20 for testing) with different beam configurations and trained our DL-model using manually-generated as well as automated ECHO plans. We evaluated different inputs: (1) CT+(PTV/OAR)contours, and (2) CT+contours+beam configurations, and different loss functions: (1) MAE (mean absolute error), and (2) MAE+DVH (dose volume histograms). The quality of the predictions was compared using different DVH metrics as well as dose-score and DVH-score, recently introduced by the AAPM knowledge-based planning grand challenge. The best results were obtained using automated ECHO plans and CT+contours+beam as training inputs and MAE+DVH as loss function.