Quantum computing for radiation therapy optimization
Robabeh Rahimi, A. Saitoh, Arezoo Modiri, Yuichiro Nakano, Ken N. Okada, Satoyuki Tsukano, Baoshe Zhang, Keisuke Fujii, Masahiro Kitagawa, Amit R. Sawant
BACKGROUND: Quantum computing (QC) is emerging as a transformative tool for solving complex optimization problems across various fields, including biomedical applications. While classical optimization methods are well-established, they frequently face limitations when applied to complex and large-scale problems in radiotherapy planning. PURPOSE: This study aims to explore the implementation and evaluate the effectiveness of quantum optimization methods, specifically quantum annealing and the quantum approximate optimization algorithm (QAOA), in radiotherapy planning. In particular, we employ an Ising Hamiltonian formulation of the cost function, empirically implementing it on annealing-based quantum hardware and for the first time on circuit-based one. METHODS: We formulated a simplified radiotherapy optimization problem and solved it using quantum annealing on a D-Wave quantum annealer. Subsequently, we adapted this optimization problem for the QAOA framework and implemented it on IBM Quantum circuit-model hardware. Comparative analyses were conducted between classical and quantum methods and implementations, highlighting QC's potential advantages and limitations in specific optimization contexts. To demonstrate that the Hamiltonian formulation is valid and practically usable, we first tested it in simplified proof-of-principle examples and then extended it to a more clinically relevant bilateral prostate proton plan. In this new example, dose parameters were extracted directly from a commercial treatment planning system (RayStation) and incorporated into the Hamiltonian optimization workflow. Both one-qubit-per-voxel and two-qubits-per-voxel encodings were evaluated to illustrate scalability. Additionally, we discussed scalability considerations, practical challenges, and future research directions necessary for integrating quantum algorithms into routine clinical radiation therapy practices. RESULTS: To our knowledge, this study presents the first demonstration of using QC circuit-model hardware for radiotherapy planning optimization. The quantum annealing approach successfully determined the optimal solution. Convergence was achieved after 20 iterations on a quantum simulator (noise free) and after 100 iterations on actual quantum hardware (due to inherent hardware noise). In the bilateral prostate proton plan derived from realistic data, the Hamiltonian-based optimization assigned higher dose to the prostate relative to surrounding organs-at-risk, confirming the feasibility of applying QC optimization directly to clinically sourced parameters. CONCLUSIONS: Quantum optimization techniques demonstrate potential advantages over classical methods, particularly in complex optimization scenarios relevant to radiation therapy. The formulation of a Hamiltonian cost function, its validation on real quantum hardware, and its application to realistic data collectively represent a first concrete step toward QC-based treatment planning optimization in medical physics. Future research should focus on addressing scalability, overcoming practical implementation challenges, and advancing the development of scalable, fault-tolerant quantum systems suitable for clinical integration.
BACKGROUND: Quantum computing (QC) is emerging as a transformative tool for solving complex optimization problems across various fields, including biomedical applications. While classical optimization methods are well-established, they frequently face limitations when applied to complex and large-scale problems in radiotherapy planning. PURPOSE: This study aims to explore the implementation and evaluate the effectiveness of quantum optimization methods, specifically quantum annealing and the quantum approximate optimization algorithm (QAOA), in radiotherapy planning. In particular, we employ an Ising Hamiltonian formulation of the cost function, empirically implementing it on annealing-based quantum hardware and for the first time on circuit-based one. METHODS: We formulated a simplified radiotherapy optimization problem and solved it using quantum annealing on a D-Wave quantum annealer. Subsequently, we adapted this optimization problem for the QAOA framework and implemented it on IBM Quantum circuit-model hardware. Comparative analyses were conducted between classical and quantum methods and implementations, highlighting QC's potential advantages and limitations in specific optimization contexts. To demonstrate that the Hamiltonian formulation is valid and practically usable, we first tested it in simplified proof-of-principle examples and then extended it to a more clinically relevant bilateral prostate proton plan. In this new example, dose parameters were extracted directly from a commercial treatment planning system (RayStation) and incorporated into the Hamiltonian optimization workflow. Both one-qubit-per-voxel and two-qubits-per-voxel encodings were evaluated to illustrate scalability. Additionally, we discussed scalability considerations, practical challenges, and future research directions necessary for integrating quantum algorithms into routine clinical radiation therapy practices. RESULTS: To our knowledge, this study presents the first demonstration of using QC circuit-model hardware for radiotherapy planning optimization. The quantum annealing approach successfully determined the optimal solution. Convergence was achieved after 20 iterations on a quantum simulator (noise free) and after 100 iterations on actual quantum hardware (due to inherent hardware noise). In the bilateral prostate proton plan derived from realistic data, the Hamiltonian-based optimization assigned higher dose to the prostate relative to surrounding organs-at-risk, confirming the feasibility of applying QC optimization directly to clinically sourced parameters. CONCLUSIONS: Quantum optimization techniques demonstrate potential advantages over classical methods, particularly in complex optimization scenarios relevant to radiation therapy. The formulation of a Hamiltonian cost function, its validation on real quantum hardware, and its application to realistic data collectively represent a first concrete step toward QC-based treatment planning optimization in medical physics. Future research should focus on addressing scalability, overcoming practical implementation challenges, and advancing the development of scalable, fault-tolerant quantum systems suitable for clinical integration.
Modern radiation oncology depends heavily on computational algorithms for inverse treatment planning, Monte Carlo dose simulations, and real-time image guidance. Classical computing architectures face critical scaling bottlenecks as clinical techniques advance toward ultra-high-resolution volumetric modulated arc therapy (VMAT) and adaptive radiotherapy. This paper explores the transformation of radiotherapy by integration of quantum computing for handling complex planning problems. Quantum computing in radiation oncology promises drastic reduction in planning time by leveraging quantum algorithms for optimization and dose estimation. Preliminary.
We apply a new hardware and software platform called the Hamiltonian Engine for Radiotherapy Optimization (HERO) to the problem of Intensity-Modulated Radiation Therapy (IMRT) treatment planning. HERO solves large general-form binary optimization problems by decomposing them into sub-problems and approximating them using a quadratic pseudo-boolean function. Optimizing the resulting function becomes a quadratic unconstrained binary optimization (QUBO) problem, which has been widely studied and has numerous applications in various fields. A Quantum Annealer (QA) approach has been previously investigated to solve QUBO problems, including IMRT optimization. However, the QA can only accommodate a small number of variables and requires several hours to obtain optimized plans. HERO acts as an optimizer for QUBO problems, which not only addresses these shortcomings but also relies solely on conventional hardware design while operating at room temperature. We evaluate HERO on seven prostate IMRT cases with clinical objectives, each using approximately 6000 beamlets. Our method was compared to the commercial treatment planning software, Eclipse, for both time-to-solution and plan quality. HERO solves most cases in about 30 seconds, with significantly lower objective function scores than Eclipse. The results indicate that HERO is promising for radiation therapy optimization problems. Additionally, HERO has the potential to be applied to Volumetric-Modulated Arc Therapy (VMAT) and other complex types of treatment planning.
Optimization methods are critical to radiation therapy. A new technology, quantum annealing (QA), employs novel hardware and software techniques to address various discrete optimization problems in many fields. We report on the first application of quantum annealing to the process of beamlet intensity optimization for IMRT. We apply recently-developed hardware which natively exploits quantum mechanical effects for improved optimization. The new algorithm, called QA, is most similar to simulated annealing, but relies on natural processes to directly minimize a system's free energy. A simple quantum system is slowly evolved into a classical system representing the objective function. If the evolution is sufficiently slow, there are probabilistic guarantees that a global minimum will be located. To apply QA to IMRT-type optimization, two prostate cases were considered. A reduced number of beamlets were employed, due to the current QA hardware limitations. The beamlet dose matrices were computed using CERR and an objective function was defined based on typical clinical constraints, including dose-volume objectives, which result in a complex non-convex search space. The objective function was discretized and the QA method was compared to two standard optimization methods, simulated annealing and Tabu search, run on a conventional computing cluster. Based on several runs, the average final objective function value achieved by the QA was 16.9 for the first patient, compared with 10.0 for Tabu and 6.7 for the simulated annealing (SA) method. For the second patient, the values were 70.7 for the QA, 120.0 for Tabu and 22.9 for the SA. The QA algorithm required 27-38% of the time required by the other two methods. In this first application of hardware-enabled QA to IMRT optimization, its performance is comparable to Tabu search, but less effective than the SA in terms of final objective function values. However, its speed was 3-4 times faster than the other two methods. This initial experiment suggests that more research into QA-based heuristics may offer significant speedup over conventional clinical optimization methods, as quantum annealing hardware scales to larger sizes.
Quantum machine learning (QML) leverages quantum phenomena such as superposition, entanglement, and interference to address computational challenges that are difficult for classical systems. In radiation oncology, where treatment planning, image guidance, adaptive replanning, and multi-modal data integration require high-dimensional optimisation and complex pattern recognition, QML may offer advantages in computational efficiency and representational capacity. This review systematically maps quantum algorithms to the clinical radiation oncology workflow. We outline foundational concepts in quantum computing, including complexity insights from the BQP class and practical constraints of the noisy intermediate-scale quantum (NISQ) era. The radiation oncology pipeline-from consultation and simulation to treatment planning, delivery, and follow-up-is analysed to identify computational bottlenecks where quantum methods could provide benefit. Current developments in quantum-enabled diagnostic modelling, quantum-inspired clinical decision support for precision radiotherapy, quantum reinforcement learning for adaptive treatment policies, and emerging concepts such as quantum digital twins are reviewed. Key challenges-including hardware limitations, barren plateaus, data encoding constraints, limited datasets, regulatory considerations, and the gap between theoretical speedups and clinical implementation-are critically examined. Finally, a three-horizon roadmap is proposed outlining near-term proof-of-concept research, mid-term integration with treatment planning systems, and long-term prospects for fault-tolerant quantum simulation in oncology.
Quantum computing has emerged as a promising computational paradigm with the potential to solve problems that are intractable for classical computers. This paper provides an overview of the current state of quantum computing, including its historical development, hardware advancements, applications, and challenges. Special attention is given to combinatorial optimization, which is considered one of the most promising application domains. The limitations of current quantum systems and future research directions are also discussed. This paper presents a comparative study between a conventional D-Wave-based simulated annealing approach and a proposed hybrid optimization model for solving largescale combinatorial optimization problems. The study focuses on benchmark problems, including AES, TSP gr24, and a real-world load balancing problem, all formulated as QUBO models. The D-Wave approach employs the dwave-neal simulated annealing engine with various parameter settings, while the proposed model introduces a decomposition-based framework combined with adaptive parameter control and iterative refinement. The experimental results demonstrate that the proposed model consistently outperforms the conventional approach in terms of solution quality, achieving significantly lower energy values across all problem instances. In particular, for the TSP gr24 problem, the proposed model achieves near-optimal solutions with substantially reduced computation time. For large-scale problems such as AES and load balancing, the proposed model maintains scalability and robustness, whereas the conventional approach suffers from increased computational cost and performance degradation. Although the proposed method introduces additional computational steps, its hybrid structure effectively mitigates limitations related to local minima, parameter sensitivity, and scalability. These findings indicate that integrating classical optimization techniques with quantum-inspired methods is essential for practical applications. The proposed model provides a promising framework for solving complex real-world optimization problems and highlights the importance of hybrid approaches in advancing quantum annealing technologies.
High-fidelity dose calculation is a still computationally intensive task in radiation therapy planning. While the Monte Carlo method is considered to be most accurate, its clinical application is often hindered by long computation times. Quantum computing offers a potential pathway to accelerate these simulations. We applied Quantum Monte Carlo integration (QMCI) as a proof-of-concept for radiotherapy dose calculation. Our QMCI framework consists of two main components: State preparation using quantum generative adversarial network (qGAN) and integration by applying quantum amplitude estimation (QAE) algorithm. We calculate the depth-dose distribution for a 6 MeV photon beam by focusing on the dominant firstorder Compton scattering. Our QMCI results closely reproduce the key features of the analytical and Geant4 reference depthdose curves, validating the framework’s potential as a scalable foundation for future, clinically relevant quantum applications in radiotherapy.