Application of a fuzzy pattern classifier to decision making in portal verification of radiotherapy.

With the large volume of electronic portal images acquired and stringent time constraints, it is no longer feasible to follow the convention whereby the radiation oncologist reviews and approves or rejects all portals. For that purpose we have developed a portal image classifier based on the fuzzy k-nearest neighbour (k-NN) algorithm. Each portal image is represented by a feature vector that consists of translational and rotational errors in the placement of radiation field borders that were measured in the portal image. Memberships in the acceptable portal class for the reference portal images within a training dataset were defined by a radiation oncologist expert. The fuzzy k-NN portal image classifier was trained and tested on a dataset of 328 portal images acquired during tangential irradiations of the breast. The memberships in the acceptable portal class produced by the fuzzy k-NN algorithm agreed very well with those defined by the expert. The linear correlation coefficient was equal to 0.89. Performance of the fuzzy k-NN classifier was also evaluated from the portal decision-making point of view using the measures of accuracy, sensitivity and specificity. The fuzzy k-NN portal classifier was capable of identifying almost all the truly unacceptable portals with an acceptably low false alarm rate.