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Incorporation of functional imaging data in the evaluation of dose distributions using the generalized concept of equivalent uniform dose.

Publication ,  Journal Article
Miften, MM; Das, SK; Su, M; Marks, LB
Published in: Phys Med Biol
May 7, 2004

Advances in the fields of IMRT and functional imaging have greatly increased the prospect of escalating the dose to highly active or hypoxic tumour sub-volumes and steering the dose away from highly functional critical structure regions. However, current clinical treatment planning and evaluation tools assume homogeneous activity/function status in the tumour/critical structures. A method was developed to incorporate tumour/critical structure heterogeneous functionality in the generalized concept of equivalent uniform dose (EUD). The tumour and critical structures functional EUD (FEUD) values were calculated from the dose-function histogram (DFH), which relates dose to the fraction of total function value at that dose. The DFH incorporates flouro-deoxyglucose positron emission tomography (FDG-PET) functional data for tumour, which describes the distribution of metabolically active tumour clonogens, and single photon emission computed tomography (SPECT) perfusion data for critical structures. To demonstrate the utility of the method, the lung dose distributions of two non-small cell lung cancer patients, who received 3D conformal external beam radiotherapy treatment with curative intent, were evaluated. Differences between the calculated lungs EUD and FEUD values of up to 50% were observed in the 3D conformal plans. In addition, a non-small cell lung cancer patient was inversely planned with a target dose prescription of 76 Gy. Two IMRT plans (plan-A and plan-B) were generated for the patient based on the CT, FDG-PET and SPECT treatment planning images using dose-volume objective functions. The IMRT plans were generated with the goal of achieving more critical structures sparing in plan-B than plan-A. Results show the target volume EUD in plan-B is lower than plan-A by 5% with a value of 73.31 Gy, and the FEUD in plan-B is lower than plan-A by 2.6% with a value of 75.77 Gy. The FEUD plan-B values for heart and lungs were lower than plan-A by 22% and 18%, respectively. While EUD values show plan-A is marginally better than plan-B in terms of target volumetric coverage, the FEUD plan-B values show adequate target function coverage with significant critical structure function sparing. In conclusion, incorporating functional data in the calculation of EUD is important in evaluating the biological merit of treatment plans.

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Published In

Phys Med Biol

DOI

ISSN

0031-9155

Publication Date

May 7, 2004

Volume

49

Issue

9

Start / End Page

1711 / 1721

Location

England

Related Subject Headings

  • Skin
  • Relative Biological Effectiveness
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiation Oncology
  • Photons
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging
  • Humans
 

Citation

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Miften, M. M., Das, S. K., Su, M., & Marks, L. B. (2004). Incorporation of functional imaging data in the evaluation of dose distributions using the generalized concept of equivalent uniform dose. Phys Med Biol, 49(9), 1711–1721. https://doi.org/10.1088/0031-9155/49/9/009
Miften, Moyed M., Shiva K. Das, Min Su, and Lawrence B. Marks. “Incorporation of functional imaging data in the evaluation of dose distributions using the generalized concept of equivalent uniform dose.Phys Med Biol 49, no. 9 (May 7, 2004): 1711–21. https://doi.org/10.1088/0031-9155/49/9/009.
Miften, Moyed M., et al. “Incorporation of functional imaging data in the evaluation of dose distributions using the generalized concept of equivalent uniform dose.Phys Med Biol, vol. 49, no. 9, May 2004, pp. 1711–21. Pubmed, doi:10.1088/0031-9155/49/9/009.
Journal cover image

Published In

Phys Med Biol

DOI

ISSN

0031-9155

Publication Date

May 7, 2004

Volume

49

Issue

9

Start / End Page

1711 / 1721

Location

England

Related Subject Headings

  • Skin
  • Relative Biological Effectiveness
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiation Oncology
  • Photons
  • Nuclear Medicine & Medical Imaging
  • Male
  • Magnetic Resonance Imaging
  • Humans