Estimation of the effects of normal tissue sparing using equivalent uniform dose-based optimization

Senthilkumar, K.; Das, K.J. Maria; Balasubramanian, Kannan; Deka, Arun; Patil, B. R.

doi:10.4103/0971-6203.181631

Cited by 8 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To improve its predictive power, EUD must be able to improve the AUC. EUD-based optimization of radiation plan has been reported in some studies (22)(23)(24). However, there is no guarantee that the parameters are generic and stable in different radiotherapy techniques (such as IMRT and SBRT).…”

Section: Discussionmentioning

confidence: 99%

Potential Defects and Improvements of Equivalent Uniform Dose Prediction Model Based on the Analysis of Radiation-Induced Brain Injury

Gan

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

PurposeTo study the impact of dose distribution on volume-effect parameter and predictive ability of equivalent uniform dose (EUD) model, and to explore the improvements.Methods and MaterialsThe brains of 103 nasopharyngeal carcinoma patients treated with IMRT were segmented according to dose distribution (brain and left/right half-brain for similar distributions but different sizes; VD with different D for different distributions). Predictive ability of EUDVD (EUD of VD) for radiation-induced brain injury was assessed by receiver operating characteristics curve (ROC) and area under the curve (AUC). The optimal volume-effect parameter a of EUD was selected when AUC was maximal (mAUC). Correlations between mAUC, a and D were analyzed by Pearson correlation analysis. Both mAUC and a in brain and half-brain were compared by using paired samples t-tests. The optimal DV and VD points were selected for a simple comparison.ResultsThe mAUC of brain/half-brain EUD was 0.819/0.821 and the optimal a value was 21.5/22. When D increased, mAUC of EUDVD increased, while a decreased. The mAUC reached the maximum value when D was 50–55 Gy, and a was always 1 when D ≥55 Gy. The difference of mAUC/a between brain and half-brain was not significant. If a was in range of 1 to 22, AUC of brain/half-brain EUDV55 Gy (0.857–0.830/0.845–0.830) was always larger than that of brain/half-brain EUD (0.681–0.819/0.691–0.821). The AUCs of optimal dose/volume points were 0.801 (brain D2.5 cc), 0.823 (brain V70 Gy), 0.818 (half-brain D1 cc), and 0.827 (half-brain V69 Gy), respectively. Mean dose (equal to EUDVD with a = 1) of high-dose volume (V50 Gy–V60 Gy) was superior to traditional EUD and dose/volume points.ConclusionVolume-effect parameter of EUD is variable and related to dose distribution. EUD with large low-dose volume may not be better than simple dose/volume points. Critical-dose-volume EUD could improve the predictive ability and has an invariant volume-effect parameter. Mean dose may be the case in which critical-dose-volume EUD has the best predictive ability.

show abstract

Section: Discussionmentioning

confidence: 99%

Potential Defects and Improvements of Equivalent Uniform Dose Prediction Model Based on the Analysis of Radiation-Induced Brain Injury

Gan

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Thus, the difference in the tumor target dose coverage may not affect the treatment benefits. Wu et al and Senthilkumar et al4,39,40 also pointed out that EUD-optimized IMRT may impact negatively on the PTV DVH curve (lower prescription dose coverage percentage and lower homogeneity versus higher hot spots on tumor). Li et al41 compared a biological IMRT optimization strategy to a physical IMRT optimization strategy among three commercial TPSs (Monaco, Pinnacle and Eclipse) and argued that although biological IMRT better spared normal tissues, the same dose coverage on target could hardly be achieved, compared to physical IMRT.…”

Section: Discussionmentioning

confidence: 99%

The benefit of using bladder sub-volume equivalent uniform dose constraints in prostate intensity-modulated radiotherapy planning

Zhu¹,

Simon²,

Haigron³

et al. 2016

OTT

View full text Add to dashboard Cite

BackgroundTo assess the benefits of bladder wall sub-volume equivalent uniform dose (EUD) constraints in prostate cancer intensity-modulated radiotherapy (IMRT) planning.MethodsTwo IMRT plans, with and without EUD constraints on the bladder wall, were generated using beams that deliver 80 Gy to the prostate and 46 Gy to the seminal vesicles and were compared in 53 prostate cancer patients. The bladder wall was defined as the volume between the external manually delineated wall and a contraction of 7 mm apart from it. The bladder wall was then separated into two parts: the internal-bladder wall (bla-in) represented by the portion of the bladder wall that intersected with the planning target volume (PTV) plus 5 mm extension; the external-bladder wall (bla-ex) represented by the remaining part of the bladder wall. In the IMRT plan with EUD constraints, the values of “a” parameter for the EUD models were 10.0 for bla-in and 2.3 for bla-ex. The plans with and without EUD constraints were compared in terms of dose–volume histograms, 5-year bladder and rectum normal tissue complication probability values, as well as tumor control probability (TCP) values.ResultsThe use of bladder sub-volume EUD constraints decreased both the doses to the bladder wall (V70: 22.76% vs 19.65%, Dmean: 39.82 Gy vs 35.45 Gy) and the 5-year bladder complication probabilities (≥LENT/SOMA Grade 2: 20.35% vs 17.96%; bladder bleeding: 10.63% vs 8.64%). The doses to the rectum wall and the rectum complication probabilities were also slightly decreased by the EUD constraints compared to physical constraints only. The minimal dose and the V76Gy of PTVprostate were, however, slightly decreased by EUD optimization, nevertheless without significant difference in TCP values between the two plans, and the PTV parameters finally respected the Groupe d’Etude des Tumeurs Uro-Génitales recommendations.ConclusionSeparating the bladder wall into two parts with appropriate EUD optimization may reduce bladder toxicity in prostate IMRT. Combining biological constraints with physical constraints in the organs at risk at the inverse planning step of IMRT may improve the dose distribution.

show abstract

“…The LKB model is well-established in NTCP calculation (31,(40)(41)(42) . BioSuite is a reliable software that has found increasing use in NTCP modeling studies (43)(44)(45)(46) .…”

Section: Radiobiological Modelingmentioning

confidence: 99%

Equivalent uniform dose and normal tissue complication probability of acute esophagitis in head-and-neck radiotherapy: Sensitivity to dose calculation accuracy

Mosleh-Shirazi

Sheikholeslami²,

Fathipour³

et al. 2022

Int J Radiat Res

View full text Add to dashboard Cite

Background: To quantify the influence of photon dose-calculation algorithm selection on the cervical esophagus (CE) dose indices and the derived equivalent uniform dose (EUD) and normal-tissue complication probability (NTCP) for acute esophagitis in patients with head-and-neck cancer (HNC). Materials and Methods: The Fast Photon Effective Path (FPEP) and Collapsed-Cone Convolution Superposition (CCCS) algorithms on the Prowess Panther treatment planning system were compared for 30 patients (six tumor sites). The Lyman-Kutcher-Burmann (LKB) model was used to calculate the EUDs and NTCPs. Results: On average, the more simplistic FPEP algorithm overestimated the mean dose to CE planning organ-at-risk volumes (PRVs) by 2.0% (p = 0.003). The average absolute difference in mean dose was 2.7% and the maximum difference was 9.3%. The V 5Gy , V 10Gy , V 15Gy , V 20Gy , V 25Gy and V 30Gy values were significantly higher with FPEP, while the point-dose and D 2cc hot spots were similar. In turn, the dose differences led to an underestimation of the LKB-model prediction of the EUD by 1.4% (p = 0.297). The mean absolute difference in EUD was 4.5% and the maximum difference was 15.3%. In the 14-50 Gy mean dose range, the resulting NTCPs with FPEP were lower on average by 2.6% than CCCS (p = 0.041). Conclusions: In the group of HNC patients considered in this study, the EUD and NTCP for acute esophagitis showed to be moderately sensitive to the choice of dose-calculation algorithm. Despite an overestimated mean dose by the simpler algorithm, the NTCP underestimation, which can be large in some patients, is of clinical concern.

show abstract

Estimation of the effects of normal tissue sparing using equivalent uniform dose-based optimization

Cited by 8 publications

References 14 publications

Potential Defects and Improvements of Equivalent Uniform Dose Prediction Model Based on the Analysis of Radiation-Induced Brain Injury

Potential Defects and Improvements of Equivalent Uniform Dose Prediction Model Based on the Analysis of Radiation-Induced Brain Injury

The benefit of using bladder sub-volume equivalent uniform dose constraints in prostate intensity-modulated radiotherapy planning

Equivalent uniform dose and normal tissue complication probability of acute esophagitis in head-and-neck radiotherapy: Sensitivity to dose calculation accuracy

Contact Info

Product

Resources

About