Journal article
On the impact of functional imaging accuracy on selective boosting IMRT
Physica medica, Vol.25(1), pp.12-24
03/01/2009
DOI: 10.1016/j.ejmp.2007.12.001
PMCID: PMC2737461
PMID: 18206411
Abstract
In order to quantify the impact of loss of functional imaging sensitivity and specificity on tumor control and normal tissue toxicity for selective boosting IMRT four selective boosting scenarios were designed: SB91-81 (EUD = 91 Gy for the high-risk tumor subvolume and EUD = 81 Gy for a remaining low-risk PTV (rPTV)), SB80-74, SB90-70, and risk-adaptive optimization.
For each sensitivity loss Level the toss in tumor control probability (ATCP) was calculated. For each specificity loss level, the increase in rectal and bladder toxicity was quantified using the radiobiological indices (equivalent uniform dose (EUD) and normal. tissue complication probability (NTCP)) as well as %-volumes irradiated.
The impact of loss in sensitivity on local tumor control was maximal. when the prescription dose level for rPTV had the lowest value. The SB90-70 plan had a 6,TCP = 29.6%, the SB91-81 plan had a ATCP = 9.5%, white for risk-adaptive optimization a ATCP = 4.7% was found. Independent of planning technique loss in functional imaging specificity appears to have a minimal impact on the expected normal tissue toxicity, since an increase in rectal, or bladder toxicity as a function of loss in specificity was not observed. Additionally, all plans fulfilled the rectum and the bladder sparing criteria found in the literature for late rectal. bleeding and genitourinary complications.
Our study shows that the choice of a low-risk classification for the rPTV in selective boosting IMRT may lead to a significant loss in TCP. Furthermore, for the example considered in which normal tissue complications can be limited through the use of a tissue expander it appears that the therapeutic ratio can be improved using a functional imaging technique with a high sensitivity and limited specificity; white for cases were this is not possible, an optimal balance between sensitivity and specificity has to be found. (C) 2009 Associazione Itatiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Details
- Title: Subtitle
- On the impact of functional imaging accuracy on selective boosting IMRT
- Creators
- Y. Kim - University of IowaW. A. Tome - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Physica medica, Vol.25(1), pp.12-24
- Publisher
- Elsevier
- DOI
- 10.1016/j.ejmp.2007.12.001
- PMID
- 18206411
- PMCID
- PMC2737461
- ISSN
- 1120-1797
- eISSN
- 1724-191X
- Number of pages
- 13
- Grant note
- R01CA109656 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) R0-1-CA109656. / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 03/01/2009
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984313087602771
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