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Title: How does performance of ultrasound tissue typing affect design of prostate IMRT dose-painting protocols?

Abstract

Purpose: To investigate how the performance characteristics of ultrasound tissue typing (UTT) affect the design of a population-based prostate dose-painting protocol. Methods and Materials: The performance of UTT is evaluated using the receiver operating characteristic curve. As the imager's sensitivity increases, more tumors are detected, but the specificity worsens, causing more false-positive results. The UTT tumor map, obtained with a specific sensitivity and specificity setup, was used with the patient's CT image to guide intensity-modulated radiotherapy (IMRT) planning. The optimal escalation dose to the UTT positive region, as well as the safe dose to the negative background, was obtained by maximizing the uncomplicated control (i.e., a combination of tumor control probability and weighted normal tissue complication probability). For high- and low-risk tumors, IMRT plans guided by conventional ultrasound or UTT with a one-dimensional or two-dimensional spectrum analysis technique were compared with an IMRT plan in which the whole prostate was dose escalated. Results: For all imaging modalities, the specificity of 0.9 was chosen to reduce complications resulting from high false-positive results. If the primary tumors were low risk, the IMRT plans guided by all imaging modalities achieved high tumor control probability and reduced the normal tissue complication probability significantly comparedmore » with the plan with whole gland dose escalation. However, if the primary tumors were high risk, the accuracy of the imaging modality was critical to maintain the tumor control probability and normal tissue complication probability at acceptable levels. Conclusion: The performance characteristics of an imager have important implications in dose painting and should be considered in the design of dose-painting protocols.« less

Authors:
 [1];  [2];  [2];  [2];  [2];  [2];  [2];  [2]
  1. Department of Radiation Oncology, Columbia University, New York, NY (United States). E-mail: pz2010@columbia.edu
  2. Department of Radiation Oncology, Columbia University, New York, NY (United States)
Publication Date:
OSTI Identifier:
20944674
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.08.061; PII: S0360-3016(06)02821-5; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; PERFORMANCE; PROSTATE; RADIATION DOSES; RADIOTHERAPY; SENSITIVITY; SPECIFICITY

Citation Formats

Zhang Pengpeng, Osterman, K. Sunshine, Liu Tian, Li Xiang, Kessel, Jack, Wu, Leester, Schiff, Peter, and Kutcher, Gerald J. How does performance of ultrasound tissue typing affect design of prostate IMRT dose-painting protocols?. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.08.061.
Zhang Pengpeng, Osterman, K. Sunshine, Liu Tian, Li Xiang, Kessel, Jack, Wu, Leester, Schiff, Peter, & Kutcher, Gerald J. How does performance of ultrasound tissue typing affect design of prostate IMRT dose-painting protocols?. United States. doi:10.1016/j.ijrobp.2006.08.061.
Zhang Pengpeng, Osterman, K. Sunshine, Liu Tian, Li Xiang, Kessel, Jack, Wu, Leester, Schiff, Peter, and Kutcher, Gerald J. Thu . "How does performance of ultrasound tissue typing affect design of prostate IMRT dose-painting protocols?". United States. doi:10.1016/j.ijrobp.2006.08.061.
@article{osti_20944674,
title = {How does performance of ultrasound tissue typing affect design of prostate IMRT dose-painting protocols?},
author = {Zhang Pengpeng and Osterman, K. Sunshine and Liu Tian and Li Xiang and Kessel, Jack and Wu, Leester and Schiff, Peter and Kutcher, Gerald J.},
abstractNote = {Purpose: To investigate how the performance characteristics of ultrasound tissue typing (UTT) affect the design of a population-based prostate dose-painting protocol. Methods and Materials: The performance of UTT is evaluated using the receiver operating characteristic curve. As the imager's sensitivity increases, more tumors are detected, but the specificity worsens, causing more false-positive results. The UTT tumor map, obtained with a specific sensitivity and specificity setup, was used with the patient's CT image to guide intensity-modulated radiotherapy (IMRT) planning. The optimal escalation dose to the UTT positive region, as well as the safe dose to the negative background, was obtained by maximizing the uncomplicated control (i.e., a combination of tumor control probability and weighted normal tissue complication probability). For high- and low-risk tumors, IMRT plans guided by conventional ultrasound or UTT with a one-dimensional or two-dimensional spectrum analysis technique were compared with an IMRT plan in which the whole prostate was dose escalated. Results: For all imaging modalities, the specificity of 0.9 was chosen to reduce complications resulting from high false-positive results. If the primary tumors were low risk, the IMRT plans guided by all imaging modalities achieved high tumor control probability and reduced the normal tissue complication probability significantly compared with the plan with whole gland dose escalation. However, if the primary tumors were high risk, the accuracy of the imaging modality was critical to maintain the tumor control probability and normal tissue complication probability at acceptable levels. Conclusion: The performance characteristics of an imager have important implications in dose painting and should be considered in the design of dose-painting protocols.},
doi = {10.1016/j.ijrobp.2006.08.061},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 67,
place = {United States},
year = {Thu Feb 01 00:00:00 EST 2007},
month = {Thu Feb 01 00:00:00 EST 2007}
}