Improved prediction of radiation pneumonitis by combining biological and radiobiological parameters using a data-driven Bayesian network analysis

Hinton, Tonaye; Karnak, David; Tang, Ming; Jiang, Ralph; Luo, Yi; Boonstra, Philip S.; Sun, Yilun; Nancarrow, Derek J.; Sandford, Erin; Ray, Paramita; Maurino, C.; Matuszak, Martha M.; Schipper, Matthew J.; Green, Michael D.; Yanik, Gregory A.; Tewari, Muneesh; Naqa, Issam El; Schonewolf, Caitlin; Haken, R. Ten; Jolly, Shruti; Lawrence, Theodore S.; Ray, Dipankar

doi:10.1016/j.tranon.2022.101428

Cited by 7 publications

(2 citation statements)

References 57 publications

(80 reference statements)

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“…T.Hinton also proposed a method by combing miRNA and cytokine data along with generalized equivalent uniform dose (gEUD) to identify pathways with better accuracy of predicting RP2+ as compared to either miRNA or cytokines alone ( 19 ). From their research it was found that the prediction performance of RP 2+was significantly improved when the lung_gEUD was adopted both in pre-treatment and during treatment (4 weeks after treatment).…”

Section: Discussionmentioning

confidence: 99%

Predicting radiation pneumonitis in lung cancer: a EUD-based machine learning approach for volumetric modulated arc therapy patients

Ye,

Xu,

Ren

et al. 2024

Front. Oncol.

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PurposeThis study aims to develop an optimal machine learning model that uses lung equivalent uniform dose (lung EUD to predict radiation pneumonitis (RP) occurrence in lung cancer patients treated with volumetric modulated arc therapy (VMAT).MethodsWe analyzed a cohort of 77 patients diagnosed with locally advanced squamous cell lung cancer (LASCLC) receiving concurrent chemoradiotherapy with VMAT. Patients were categorized based on the onset of grade II or higher radiation pneumonitis (RP 2+). Dose volume histogram data, extracted from the treatment planning system, were used to compute the lung EUD values for both groups using a specialized numerical analysis code. We identified the parameter α, representing the most significant relative difference in lung EUD between the two groups. The predictive potential of variables for RP2+, including physical dose metrics, lung EUD, normal tissue complication probability (NTCP) from the Lyman-Kutcher-Burman (LKB) model, and lung EUD-calibrated NTCP for affected and whole lung, underwent both univariate and multivariate analyses. Relevant variables were then employed as inputs for machine learning models: multiple logistic regression (MLR), support vector machine (SVM), decision tree (DT), and K-nearest neighbor (KNN). Each model's performance was gauged using the area under the curve (AUC), determining the best-performing model.ResultsThe optimal α-value for lung EUD was 0.3, maximizing the relative lung EUD difference between the RP 2+ and non-RP 2+ groups. A strong correlation coefficient of 0.929 (P< 0.01) was observed between lung EUD (α = 0.3) and physical dose metrics. When examining predictive capabilities, lung EUD-based NTCP for the affected lung (AUC: 0.862) and whole lung (AUC: 0.815) surpassed LKB-based NTCP for the respective lungs. The decision tree (DT) model using lung EUD-based predictors emerged as the superior model, achieving an AUC of 0.98 in both training and validation datasets.DiscussionsThe likelihood of developing RP 2+ has shown a significant correlation with the advancements in RT technology. From traditional 3-D conformal RT, lung cancer treatment methodologies have transitioned to sophisticated techniques like static IMRT. Accurately deriving such a dose–effect relationship through NTCP modeling of RP incidence is statistically challenging due to the increased number of degrees-of-freedom. To the best of our knowledge, many studies have not clarified the rationale behind setting the α-value to 0.99 or 1, despite the closely aligned calculated lung EUD and lung mean dose MLD. Perfect independence among variables is rarely achievable in real-world scenarios. Four prominent machine learning algorithms were used to devise our prediction models. The inclusion of lung EUD-based factors substantially enhanced their predictive performance for RP 2+. Our results advocate for the decision tree model with lung EUD-based predictors as the optimal prediction tool for VMAT-treated lung cancer patients. Which could replace conventional dosimetric parameters, potentially simplifying complex neural network structures in prediction models.

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Section: Discussionmentioning

confidence: 99%

Predicting radiation pneumonitis in lung cancer: a EUD-based machine learning approach for volumetric modulated arc therapy patients

Ye,

Xu,

Ren

et al. 2024

Front. Oncol.

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“…These include “simple” decision trees, regression models such as least absolute shrinkage and selection operator (LASSO), and Bayesian probabilistic causal networks, though these are not applicable to all clinical problems/models. 89 , 90 , 91 , 92 , 93 , 94 , 95 …”

Section: Current Challenges To Applying Ai To Lung Cancermentioning

confidence: 99%