Integral dose based inverse optimization objective function promises lower toxicity in head-and-neck

Ivaylo B Mihaylov, Eduardo G. Moros

Research output: Contribution to journalArticle

Abstract

Purpose: The voxels in a CT data sets contain density information. Besides its use in dose calculation density has no other application in modern radiotherapy treatment planning. This work introduces the use of density information by integral dose minimization in radiotherapy treatment planning for head-and-neck squamous cell carcinoma (HNSCC). Materials and methods: Eighteen HNSCC cases were studied. For each case two intensity modulated radiotherapy (IMRT) plans were created: one based on dose-volume (DV) optimization, and one based on integral dose minimization (Energy hereafter) inverse optimization. The target objective functions in both optimization schemes were specified in terms of minimum, maximum, and uniform doses, while the organs at risk (OAR) objectives were specified in terms of DV- and Energy-objectives respectively. Commonly used dosimetric measures were applied to assess the performance of Energy-based optimization. In addition, generalized equivalent uniform doses (gEUDs) were evaluated. Statistical analyses were performed to estimate the performance of this novel inverse optimization paradigm. Results: Energy-based inverse optimization resulted in lower OAR doses for equivalent target doses and isodose coverage. The statistical tests showed dose reduction to the OARs with Energy-based optimization ranging from ∼2% to ∼15%. Conclusions: Integral dose minimization based inverse optimization for HNSCC promises lower doses to nearby OARs. For comparable therapeutic effect the incorporation of density information into the optimization cost function allows reduction in the normal tissue doses and possibly in the risk and the severity of treatment related toxicities.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
JournalPhysica Medica
Volume54
DOIs
StatePublished - Oct 1 2018

Fingerprint

toxicity
Organs at Risk
Neck
Head
dosage
optimization
Radiotherapy
Intensity-Modulated Radiotherapy
Therapeutic Uses
Therapeutics
Costs and Cost Analysis
radiation therapy
cancer
organs
Carcinoma, squamous cell of head and neck
planning
energy
statistical tests
costs
Datasets

Keywords

  • Dose
  • Imaging
  • IMRT
  • Integral dose
  • Mass
  • Optimization

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)

Cite this

Integral dose based inverse optimization objective function promises lower toxicity in head-and-neck. / Mihaylov, Ivaylo B; Moros, Eduardo G.

In: Physica Medica, Vol. 54, 01.10.2018, p. 77-83.

Research output: Contribution to journalArticle

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abstract = "Purpose: The voxels in a CT data sets contain density information. Besides its use in dose calculation density has no other application in modern radiotherapy treatment planning. This work introduces the use of density information by integral dose minimization in radiotherapy treatment planning for head-and-neck squamous cell carcinoma (HNSCC). Materials and methods: Eighteen HNSCC cases were studied. For each case two intensity modulated radiotherapy (IMRT) plans were created: one based on dose-volume (DV) optimization, and one based on integral dose minimization (Energy hereafter) inverse optimization. The target objective functions in both optimization schemes were specified in terms of minimum, maximum, and uniform doses, while the organs at risk (OAR) objectives were specified in terms of DV- and Energy-objectives respectively. Commonly used dosimetric measures were applied to assess the performance of Energy-based optimization. In addition, generalized equivalent uniform doses (gEUDs) were evaluated. Statistical analyses were performed to estimate the performance of this novel inverse optimization paradigm. Results: Energy-based inverse optimization resulted in lower OAR doses for equivalent target doses and isodose coverage. The statistical tests showed dose reduction to the OARs with Energy-based optimization ranging from ∼2{\%} to ∼15{\%}. Conclusions: Integral dose minimization based inverse optimization for HNSCC promises lower doses to nearby OARs. For comparable therapeutic effect the incorporation of density information into the optimization cost function allows reduction in the normal tissue doses and possibly in the risk and the severity of treatment related toxicities.",
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