Impact of interpatient variability on organ dose estimates according to MIRD schema: Uncertainty and variance‐based sensitivity analysis

Zvereva, Alexandra; Kamp, Alexandra; Schlattl, Helmut; Zankl, M.; Parodi, Katia

doi:10.1002/mp.12984

Cited by 19 publications

(30 citation statements)

References 26 publications

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“…interpatient variability on organ dose estimates 16 . In this feasibility study, we present a framework to apply the technique of global, variance-based SA to uncertainties in proton therapy, explicitly modeling RBE, range and setup errors.…”

Section: Accepted Articlementioning

confidence: 99%

“…The positions are defined on a 2D regular grid in the BEV coordinate system. During dose calculation, the algorithm has to select the correct neighbor raytracing to replace based on the lateral offsets and from equation 15and * ∆ ∆ (16). This method is similar to the "virtual beamlets" approach proposed by Unkelbach et al 38 , with the difference, that in our approach only the raytracing is approximated by the neighbor which is closest to the patient shift, while the lateral part in equation 12is modeled exactly according to equations (15) and (16).…”

Section: Accepted Articlementioning

confidence: 99%

“…During dose calculation, the algorithm has to select the correct neighbor raytracing to replace based on the lateral offsets and from equation 15and * ∆ ∆ (16). This method is similar to the "virtual beamlets" approach proposed by Unkelbach et al 38 , with the difference, that in our approach only the raytracing is approximated by the neighbor which is closest to the patient shift, while the lateral part in equation 12is modeled exactly according to equations (15) and (16). The approach to keep pre-calculated neighboring raytracings for every PBS spot is memory intensive, however, since only small setup-errors are expected and need to be treated in the SA, sets of only a few shifts of up to a few millimeters are sufficient.…”

Section: Accepted Articlementioning

confidence: 99%

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Variance‐based sensitivity analysis for uncertainties in proton therapy: A framework to assess the effect of simultaneous uncertainties in range, positioning, and RBE model predictions on RBE‐weighted dose distributions

Hofmaier

Dedes²,

Carlson

et al. 2020

Medical Physics

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Treatment plans in proton therapy are more sensitive to uncertainties than in conventional photon therapy. In addition to setup uncertainties, proton therapy is affected by uncertainties in proton range and relative biological effectiveness (RBE). While to date a constant RBE of 1.1 is commonly assumed, the actual RBE is known to increase towards the distal end of the spread-out Bragg peak. Several models for variable RBE predictions exist. We present a framework to evaluate the combined impact and interactions of setup, range and RBE uncertainties in a comprehensive, variance-based sensitivity analysis (SA). Material and Methods: The variance-based SA requires a large number (10 4-10 5) of RBE-weighted dose (RWD) calculations. Based on a particle therapy extension of the research treatment planning system CERR we implemented a fast, graphics processing unit (GPU) accelerated pencil beam modeling of patient and range shifts. For RBE predictions, two biological models were included: The mechanistic repairmisrepair-fixation (RMF) model and the phenomenological Wedenberg model. All input parameters (patient position, proton range, RBE model parameters) are sampled simultaneously within their assumed probability distributions. Statistical formalisms rank the input parameters according to their influence on the overall uncertainty of RBE-weighted dose-volume histogram (RW-DVH) quantiles and the RWD in every voxel, resulting in relative, normalized sensitivity indices (S=0: non influential input, S=1: only influential input). Results are visualized as RW-DVHs with error bars and sensitivity maps. Results and Conclusions: The approach is demonstrated for two representative brain tumor cases and a prostate case. The full SA including RWD calculations took 39,11 and 55 minutes, respectively. ∼ 3 × 10 4 Range uncertainty was an important contribution to overall uncertainty at the distal end of the target, while the relatively smaller uncertainty inside the target was governed by biological uncertainties. Consequently, the uncertainty of the RW-DVH quantile D 98 for the target was governed by range uncertainty while the uncertainty of the mean target dose was dominated by the biological parameters. The SA framework is a powerful and flexible tool to evaluate uncertainty in RWD distributions and DVH quantiles, taking into account physical and RBE uncertainties and their interactions. The additional information might help to prioritize research efforts to reduce physical and RBE uncertainties and could also have implications for future approaches to biologically robust planning and optimization.

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Section: Accepted Articlementioning

confidence: 99%

Section: Accepted Articlementioning

confidence: 99%

Section: Accepted Articlementioning

confidence: 99%

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Variance‐based sensitivity analysis for uncertainties in proton therapy: A framework to assess the effect of simultaneous uncertainties in range, positioning, and RBE model predictions on RBE‐weighted dose distributions

Hofmaier

Dedes²,

Carlson

et al. 2020

Medical Physics

Self Cite

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“…the proof of a 95% confidence interval that one worker is more sensitive than another). A study on variability on organ dose estimated relative uncertainties in the range of 10%-30% (Zvereva et al 2018). Other publications discussed various aspects of uncertainties in risk estimates (UNSCEAR 2012b;Fisher and Fahey 2017;Ulanowski et al 2019) including competing risks and effective dose.…”

Section: Uncertaintiesmentioning

confidence: 99%

Clinical and epidemiological observations on individual radiation sensitivity and susceptibility

Seibold

Auvinen

Averbeck

et al. 2019

International Journal of Radiation Biology

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Purpose: To summarize existing knowledge and to understand individual response to radiation exposure, the MELODI Association together with CONCERT European Joint Programme has organized a workshop in March 2018 on radiation sensitivity and susceptibility. Methods: The workshop reviewed the current evidence on this matter, to inform the MELODI Strategic Research Agenda (SRA), to determine social and scientific needs and to come up with recommendations for suitable and feasible future research initiatives to be taken for the benefit of an improved medical diagnosis and treatment as well as for radiation protection. Results: The present paper gives an overview of the current evidence in this field, including potential effect modifiers such as age, gender, genetic profile, and health status of the exposed population, based on clinical and epidemiological observations. Conclusion: The authors conclude with the following recommendations for the way forward in radiation research: (a) there is need for large (prospective) cohort studies; (b) build upon existing radiation research cohorts; (c) use data from well-defined cohorts with good exposure assessment and biological material already collected; (d) focus on study quality with standardized data collection and reporting; (e) improve statistical analysis; (f) cooperation between radiobiology and epidemiology; and (g) take consequences of radiosensitivity and radiosusceptibility into account.

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“…and delivered organ radiation dose depends on which particular radiopharmaceutical is used. 27 Organ doses are estimated for patients in general, not assessed individually on a patient-by-patient basis. Efforts are ongoing to combine PET with CT scans to produce a detailed map of radiation dose delivered to individual organs for individual patients for radiotherapy procedures such as 131 I therapy for thyroid cancer.…”

mentioning

confidence: 99%

Balancing risks and rewards in assessing pediatric heart disease

Nichols

Gecelter

Tosh

2021

Journal of Nuclear Cardiology

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Impact of interpatient variability on organ dose estimates according to MIRD schema: Uncertainty and variance‐based sensitivity analysis

Cited by 19 publications

References 26 publications

Variance‐based sensitivity analysis for uncertainties in proton therapy: A framework to assess the effect of simultaneous uncertainties in range, positioning, and RBE model predictions on RBE‐weighted dose distributions

Variance‐based sensitivity analysis for uncertainties in proton therapy: A framework to assess the effect of simultaneous uncertainties in range, positioning, and RBE model predictions on RBE‐weighted dose distributions

Clinical and epidemiological observations on individual radiation sensitivity and susceptibility

Balancing risks and rewards in assessing pediatric heart disease

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