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Title: A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage

Abstract

Purpose: To apply a voxel-based (VB) approach aimed at exploring local dose differences associated with late radiation-induced lung damage (RILD). Methods and Materials: An interinstitutional database of 98 patients who were Hodgkin lymphoma (HL) survivors treated with postchemotherapy supradiaphragmatic radiation therapy was analyzed in the study. Eighteen patients experienced late RILD, classified according to the Radiation Therapy Oncology Group scoring system. Each patient's computed tomographic (CT) scan was normalized to a single reference case anatomy (common coordinate system, CCS) through a log-diffeomorphic approach. The obtained deformation fields were used to map the dose of each patient into the CCS. The coregistration robustness and the dose mapping accuracy were evaluated by geometric and dose scores. Two different statistical mapping schemes for nonparametric multiple permutation inference on dose maps were applied, and the corresponding P<.05 significance lung subregions were generated. A receiver operating characteristic (ROC)-based test was performed on the mean dose extracted from each subregion. Results: The coregistration process resulted in a geometrically robust and accurate dose warping. A significantly higher dose was consistently delivered to RILD patients in voxel clusters near the peripheral medial-basal portion of the lungs. The area under the ROC curves (AUC) from the mean dose ofmore » the voxel clusters was higher than the corresponding AUC derived from the total lung mean dose. Conclusions: We implemented a framework including a robust registration process and a VB approach accounting for the multiple comparison problem in dose-response modeling, and applied it to a cohort of HL survivors to explore a local dose–RILD relationship in the lungs. Patients with RILD received a significantly greater dose in parenchymal regions where low doses (∼6 Gy) were delivered. Interestingly, the relation between differences in the high-dose range and RILD seems to lack a clear spatial signature.« less

Authors:
 [1];  [2];  [1];  [1];  [3];  [1];  [4];  [5];  [6];  [1];  [1];  [3];  [1]
  1. Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy)
  2. IRCCS SDN, Naples (Italy)
  3. (Italy)
  4. Department of Health Physics, S. Camillo-Forlanini Hospital, Rome (Italy)
  5. Department of Radiation Oncology, S. Camillo-Forlanini Hospital, Rome (Italy)
  6. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY (United States)
Publication Date:
OSTI Identifier:
22648789
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The 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; COMPUTERIZED TOMOGRAPHY; DAMAGE; GY RANGE 01-10; LUNGS; MAPPING; PATIENTS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Palma, Giuseppe, Monti, Serena, D'Avino, Vittoria, Conson, Manuel, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Liuzzi, Raffaele, Pressello, Maria Cristina, Donato, Vittorio, Deasy, Joseph O., Quarantelli, Mario, Pacelli, Roberto, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, and Cella, Laura, E-mail: laura.cella@cnr.it. A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.033.
Palma, Giuseppe, Monti, Serena, D'Avino, Vittoria, Conson, Manuel, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Liuzzi, Raffaele, Pressello, Maria Cristina, Donato, Vittorio, Deasy, Joseph O., Quarantelli, Mario, Pacelli, Roberto, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, & Cella, Laura, E-mail: laura.cella@cnr.it. A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage. United States. doi:10.1016/J.IJROBP.2016.04.033.
Palma, Giuseppe, Monti, Serena, D'Avino, Vittoria, Conson, Manuel, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Liuzzi, Raffaele, Pressello, Maria Cristina, Donato, Vittorio, Deasy, Joseph O., Quarantelli, Mario, Pacelli, Roberto, Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, and Cella, Laura, E-mail: laura.cella@cnr.it. Thu . "A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage". United States. doi:10.1016/J.IJROBP.2016.04.033.
@article{osti_22648789,
title = {A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage},
author = {Palma, Giuseppe and Monti, Serena and D'Avino, Vittoria and Conson, Manuel and Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples and Liuzzi, Raffaele and Pressello, Maria Cristina and Donato, Vittorio and Deasy, Joseph O. and Quarantelli, Mario and Pacelli, Roberto and Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples and Cella, Laura, E-mail: laura.cella@cnr.it},
abstractNote = {Purpose: To apply a voxel-based (VB) approach aimed at exploring local dose differences associated with late radiation-induced lung damage (RILD). Methods and Materials: An interinstitutional database of 98 patients who were Hodgkin lymphoma (HL) survivors treated with postchemotherapy supradiaphragmatic radiation therapy was analyzed in the study. Eighteen patients experienced late RILD, classified according to the Radiation Therapy Oncology Group scoring system. Each patient's computed tomographic (CT) scan was normalized to a single reference case anatomy (common coordinate system, CCS) through a log-diffeomorphic approach. The obtained deformation fields were used to map the dose of each patient into the CCS. The coregistration robustness and the dose mapping accuracy were evaluated by geometric and dose scores. Two different statistical mapping schemes for nonparametric multiple permutation inference on dose maps were applied, and the corresponding P<.05 significance lung subregions were generated. A receiver operating characteristic (ROC)-based test was performed on the mean dose extracted from each subregion. Results: The coregistration process resulted in a geometrically robust and accurate dose warping. A significantly higher dose was consistently delivered to RILD patients in voxel clusters near the peripheral medial-basal portion of the lungs. The area under the ROC curves (AUC) from the mean dose of the voxel clusters was higher than the corresponding AUC derived from the total lung mean dose. Conclusions: We implemented a framework including a robust registration process and a VB approach accounting for the multiple comparison problem in dose-response modeling, and applied it to a cohort of HL survivors to explore a local dose–RILD relationship in the lungs. Patients with RILD received a significantly greater dose in parenchymal regions where low doses (∼6 Gy) were delivered. Interestingly, the relation between differences in the high-dose range and RILD seems to lack a clear spatial signature.},
doi = {10.1016/J.IJROBP.2016.04.033},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}