Deep-Learning for Rapid Estimation of the Out-of-Field Dose in External Beam Photon Radiation Therapy – A Proof of Concept

Benzazon, Nathan; Carré, Alexandre; de Kermenguy, François; Niyoteka, Stéphane; Maury, Pauline; Colnot, Julie; M'hamdi, Meissane; Aichi, Mohammed El; Veres, Cristina; Allodji, Rodrigue; de Vathaire, Florent; Sarrut, David; Journy, Neige; Alapetite, Claire; Grégoire, Vincent; Deutsch, Eric; Diallo, Ibrahima; Robert, Charlotte

doi:10.1016/j.ijrobp.2024.03.007

Cited by 1 publication

(1 citation statement)

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“…The fraction of lymphocytes in H&N SCLNs was not patient-specific and assumed a homogeneous distribution of lymphocytes between all SCLNs, and the code used to calculate the OOF dose was trained on paediatric OOF dose data (161 of whom were over 15 years old) from old-generation accelerators and probably overestimates OOF doses. Even if the neural network showed good performance in inferring OOF dose from unknown machines (irradiators not included in the training set), especially for close to the field regions (Benzazon et al 2024), experimental measurements are required to validate these results. Finally, it would be interesting to consider the whole-body OOF dose to lymphoid structure, and not just in the H&N lymph nodes.…”

Section: Modelmentioning

confidence: 99%

LymphoDose: a lymphocyte dose estimation framework—application to brain radiotherapy

de Kermenguy,

Benzazon,

Maury

et al. 2024

Phys. Med. Biol.

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Objective: Severe radiation-induced lymphopenia occurs in 40% of patients treated for primary brain tumors and is an independent risk factor of poor survival outcomes. We developed an in-silico framework that estimates the radiation doses received by lymphocytes during VMAT brain irradiation. Approach: We implemented a simulation consisting of two interconnected compartmental models describing the slow recirculation of lymphocytes between lymphoid organs (M_1) and the bloodstream (M_2). We used dosimetry data from 33 patients treated with chemo-radiation for glioblastoma to compare three cases of the model, corresponding to different physical and biological scenarios: H1) lymphocytes circulation only in the bloodstream i.e., circulation in M_2 only; H2) lymphocytes recirculation between lymphoid organs i.e. circulation in M_1 and M_2 interconnected; H3) lymphocytes recirculation between lymphoid organs and deep-leaning computed out-of-field dose to head and neck lymphoid structures. A sensitivity analysis of the model's parameters was also performed. Main results: For H1, H2 and H3 cases respectively, the irradiated fraction of lymphocytes was 99.8±0.7%, 40.4±10.2% et 97.6±2.5%, and the average dose to irradiated pool was 309.9±74.7mGy, 52.6±21.1mGy and 265.6±48.5mGy. The recirculation process considered in the H2 case implied that irradiated lymphocytes were irradiated in the field only 1.58±0.91 times on average after treatment. The out-of-field irradiation of head and neck lymphoid structures considered in H3 was an important contribution to lymphocytes dose. In all cases, the estimated doses are low compared with lymphocytes radiosensitivity, and other mechanisms could explain high prevalence of RIL in patients with brain tumors.Significance: Our framework is the first to take into account out-of-field doses and recirculation in lymphocyte dose assessment during brain irradiation. Our results demonstrate the need to clarify the indirect effects of irradiation on lymphopenia, in order to potentiate the combination of radio-immunotherapy or the abscopal effect.

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Section: Modelmentioning

confidence: 99%