Incorporation of functional status into dose‐volume analysis

Marks, Lawrence B.; Sherouse, George W.; Munley, Michael T.; Bentel, Gunilla C.; Spencer, David P.

doi:10.1118/1.598503

Cited by 79 publications

(53 citation statements)

References 23 publications

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“…For the lungs, the following dose-volume metrics were investigated: the mean lung dose (MLD), V 20 , and effective dose (D eff ) [28]. We also calculated the dose-function histogram (DFH) [29] and the following dose-function metrics: fV 20 , functional MLD (fMLD) [30], and functional effective dose (fD eff ) [7]. Vinogradskiy et al demonstrated a higher predictive power of these dose-function metrics for pneumonitis compared to dose-volume metrics [7].…”

Section: Discussionmentioning

confidence: 99%

CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based plans

Kida

Bal

Kabus

et al. 2016

Radiotherapy and Oncology

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Radiation-induced lung injury has detrimental effects on lung function and is associated with radiation pneumonitis, which is a potentially fatal toxicity and occurs in up to 30% of lung cancer patients treated with radiotherapy [1,2]. Radiotherapy that selectively avoids irradiating highly-functional lung regions may reduce pulmonary toxicity [3][4][5]. This hypothesis is supported by several reports in the literature. Lung dose-function metrics were found to improve predictive power for pulmonary toxicity compared to dose-volume metrics [6,7]. The mean functional V 20 (fV 20 ) (percent lung function receiving P20 Gy) for patients who developed Grade P3 pneumonitis was 4.3% greater (p = 0.09) than those who did not, and it was closer to statistical significance than the V 20 (percent lung volume receiving P20 Gy) (p = 0.33) [7].Several modalities exist for pulmonary ventilation imaging [8][9][10][11]. Ventilation images can also be acquired by a method based on four-dimensional (4D) computed tomography (CT) and image processing/analysis [12,13], henceforth referred to as CT ventilation imaging. CT ventilation imaging has the potential for widespread clinical implementation, as 4D-CT is routinely acquired for treatment planning at many centers [14] and ventilation computation only involves image processing/analysis without extra scans to patients. Additionally, CT ventilation imaging has a shorter scan time, higher spatial resolution (the exact resolution is unknown), lower cost, and/or greater availability than other modalities.Validation studies for CT ventilation imaging have been focused on cross-modality image comparisons [15][16][17][18][19][20][21][22]. For example, studies with mechanically ventilated sheep have demonstrated strong correlations between CT ventilation and xenon-CT ventilation [15,16]. Human studies have also reported reasonable correlations with ventilation scintigraphy [21], single-photon emission CT (SPECT) ventilation [22] and other modalities [19,20]. Previously we have demonstrated that CT ventilation in SPECT ventilationdefined defect regions of interest (ROIs) is significantly lower than http://dx

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Section: Discussionmentioning

confidence: 99%

CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based plans

Kida

Bal

Kabus

et al. 2016

Radiotherapy and Oncology

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“…3D dose distributions were calculated using tissue inhomogeneity corrections [24][25][26][27]. Lung contours were defined using an automatic threshold method and edited as appropriate to exclude the gross tumor and the bronchus [3].…”

Section: Clinical Evaluation Treatment Planning and Follow-upmentioning

confidence: 99%

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

et al. 2006

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The purpose of the study was to reassess the utility of transforming growth factor-beta-1 (TGF-β1) together with dosimetric and tumor parameters as a predictor for radiation pneumonitis (RP). Of the 121 patients studied, 32 (26.4%) developed grade ≥ 1 RP, and 27 (22.3%) developed grade ≥ 2 RP. For the endpoint of grade ≥ 1 RP, those with V30 > 30% and an end-RT/baseline TGF-β1 ratio ≥ 1 had a significantly higher incidence of RP than did those with V30 > 30% and an end-RT/baseline TGF-β1 ratio < 1. For most other patient groups, there were no clear associations between TGF-β1 values and rates of RP. These findings suggest that TGF-β1 is generally not predictive for RP except for the group of patients with a high V30.

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“…Based on the concept of the dose-function parameters of Marks et al [8] , we measured the radioactivity counts of GSA-SPECT and incorporated the quantities in both the ≥20 Gyirradiated FL area and the whole liver. We then obtained the cutoff value for F20Gy, whose accuracy (0.913) in predicting RILD surpassed the accuracy (0.826) of FLV20Gy in the ROC analysis.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is difficult for the dose-volume parameters to accommodate the degree of liver function strength or to evaluate the severity of liver cirrhosis. Therefore, based on the report of Marks et al [8] , the concept of dose-function parameters was adopted to resolve the problem of the inhomogeneity of liver function strength. Percentage F20Gy was defined with the following formula: GSA counts within the liver area irradiated with ≥20 Gy ×100/GSA counts in the whole liver ( Figure 1).…”

Section: Dose-function Parametersmentioning

confidence: 99%

“…To replace the dose-volume histogram, Marks et al proposed the idea of a dose-function histogram to merge the function of the organ bearing the tumor with the radiation dose distribution curve created by radiation treatment planning [8] . In planning radiation treatment for lung cancer, they used lung perfusion single-photon-emission computed tomography (SPECT) counts of Tc-99m macro-aggregated albumin as the lung function digital data to create the dose-function histogram [8] . Therefore, in this study, we attempted to create a cutoff value to predict RILD more exactly than FLV20Gy using Tc-99m GSA counts as the liver function digital data [6] .…”

Section: Introductionmentioning

confidence: 99%

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Cutoff Values for Dose-liver Function Parameters to Prevent Radiation-induced Liver Disease in Advanced Hepatoma

Shirai

Kumayama

Sato

et al. 2015

Journal of Gastroenterology and Hepatology Research

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AIM:To retrospectively explore the cutoff values that predict radiation-induced liver disease (RILD) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) in the main trunk and/or the first branch who had previously received singlephoton-emission computed tomography (SPECT)-based threedimensional conformal radiotherapy (3DCRT; SPECT-B-3DCRT) using Tc-99m-galactosyl human serum albumin (Tc-99m GSA). METHODS: Seventy-five HCC patients with PVTT underwent SPECT-B-3DCRT (total dose of 45 Gy/18 fractions) in the stopbreathing position with an error of ≤5 mm. SPECT allowed the minimum possible irradiation of the functional liver (FL). ChildPugh score deterioration (CPSD) by 2 (=RILD) or CPSD by 1 was scored within four months of completing SPECT-B-3DCRT. Receiver-operating characteristic (ROC) analysis of the outcomes RILD vs CPSD by 1 was conducted to determine the accuracy and cutoff values for FLV20Gy (percentage of FL volume receiving ≥20 Gy), F20Gy (GSA counts within the irradiated liver area receiving ≥20 Gy ×100/GSA counts in the whole liver), F20Gy/LHL15 (liver radioactivity counts at 15 min/heart plus liver radioactivity counts at 15 min), and F20Gy/total count ratio (liver radioactivity counts/liver plus total background radioactivity counts). RESULTS:The cutoff values and accuracy of FLV20Gy, F20Gy, F20Gy/ LHL15, and F20Gy/total count ratio were 26.4 and 0.826 (p=0.024), 30.2 and 0.913 (p=0.004), 37.7 and 0.913 (p=0.001), and 43.0 and 0.957 (p<0.001), respectively. CONCLUSION: An F20Gy/total count ratio of 43.0 is the most reliable cutoff value for preventing RILD.

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Incorporation of functional status into dose‐volume analysis

Cited by 79 publications

References 23 publications

CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based plans

CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based plans

Does transforming growth factor-β1 predict for radiation-induced pneumonitis in patients treated for lung cancer?

Cutoff Values for Dose-liver Function Parameters to Prevent Radiation-induced Liver Disease in Advanced Hepatoma

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