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Article: Modeling Patient-Specific Dose-Function Response for Enhanced Characterization of Personalized Functional Damage

TitleModeling Patient-Specific Dose-Function Response for Enhanced Characterization of Personalized Functional Damage
Authors
Issue Date2018
Citation
International Journal of Radiation Oncology Biology Physics, 2018, v. 102, n. 4, p. 1265-1275 How to Cite?
Abstract© 2018 Elsevier Inc. Purpose: Functional-guided radiation therapy (RT) plans have the potential to limit damage to normal tissue and reduce toxicity. Although functional imaging modalities have continued to improve, a limited understanding of the functional response to radiation and its application to personalized therapy has hindered clinical implementation. The purpose of this study was to retrospectively model the longitudinal, patient-specific dose-function response in non-small cell lung cancer patients treated with RT to better characterize the expected functional damage in future, unknown patients. Methods and Materials: Perfusion single-photon emission computed tomography/computed tomography scans were obtained at baseline (n = 81), midtreatment (n = 74), 3 months post-treatment (n = 51), and 1 year post-treatment (n = 26) and retrospectively analyzed. Patients were treated with conventionally fractionated RT or stereotactic body RT. Normalized perfusion single-photon emission computed tomography voxel intensity was used as a surrogate for local lung function. A patient-specific logistic model was applied to each individual patient's dose-function response to characterize functional reduction at each imaging time point. Patient-specific model parameters were averaged to create a population-level logistic dose-response model. Results: A significant longitudinal decrease in lung function was observed after RT by analyzing the voxelwise change in normalized perfusion intensity. Generated dose-function response models represent the expected voxelwise reduction in function, and the associated uncertainty, for an unknown patient receiving conventionally fractionated RT or stereotactic body RT. Differential treatment responses based on the functional status of the voxel at baseline suggest that initially higher functioning voxels are damaged at a higher rate than lower functioning voxels. Conclusions: This study modeled the patient-specific dose-function response in patients with non-small cell lung cancer during and after radiation treatment. The generated population-level dose-function response models were derived from individual patient assessment and have the potential to inform functional-guided treatment plans regarding the expected functional lung damage. This type of patient-specific modeling approach can be applied broadly to other functional response analyses to better capture intrapatient dependencies and characterize personalized functional damage.
Persistent Identifierhttp://hdl.handle.net/10722/267104
ISSN
2017 Impact Factor: 5.554
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorOwen, Daniel Rocky-
dc.contributor.authorBoonstra, Phillip S.-
dc.contributor.authorViglianti, Benjamin L.-
dc.contributor.authorBalter, James M.-
dc.contributor.authorSchipper, Matthew J.-
dc.contributor.authorJackson, William C.-
dc.contributor.authorEl Naqa, Issam-
dc.contributor.authorJolly, Shruti-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorKong, Feng Ming Spring-
dc.contributor.authorMatuszak, Martha M.-
dc.date.accessioned2019-01-31T07:20:31Z-
dc.date.available2019-01-31T07:20:31Z-
dc.date.issued2018-
dc.identifier.citationInternational Journal of Radiation Oncology Biology Physics, 2018, v. 102, n. 4, p. 1265-1275-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/267104-
dc.description.abstract© 2018 Elsevier Inc. Purpose: Functional-guided radiation therapy (RT) plans have the potential to limit damage to normal tissue and reduce toxicity. Although functional imaging modalities have continued to improve, a limited understanding of the functional response to radiation and its application to personalized therapy has hindered clinical implementation. The purpose of this study was to retrospectively model the longitudinal, patient-specific dose-function response in non-small cell lung cancer patients treated with RT to better characterize the expected functional damage in future, unknown patients. Methods and Materials: Perfusion single-photon emission computed tomography/computed tomography scans were obtained at baseline (n = 81), midtreatment (n = 74), 3 months post-treatment (n = 51), and 1 year post-treatment (n = 26) and retrospectively analyzed. Patients were treated with conventionally fractionated RT or stereotactic body RT. Normalized perfusion single-photon emission computed tomography voxel intensity was used as a surrogate for local lung function. A patient-specific logistic model was applied to each individual patient's dose-function response to characterize functional reduction at each imaging time point. Patient-specific model parameters were averaged to create a population-level logistic dose-response model. Results: A significant longitudinal decrease in lung function was observed after RT by analyzing the voxelwise change in normalized perfusion intensity. Generated dose-function response models represent the expected voxelwise reduction in function, and the associated uncertainty, for an unknown patient receiving conventionally fractionated RT or stereotactic body RT. Differential treatment responses based on the functional status of the voxel at baseline suggest that initially higher functioning voxels are damaged at a higher rate than lower functioning voxels. Conclusions: This study modeled the patient-specific dose-function response in patients with non-small cell lung cancer during and after radiation treatment. The generated population-level dose-function response models were derived from individual patient assessment and have the potential to inform functional-guided treatment plans regarding the expected functional lung damage. This type of patient-specific modeling approach can be applied broadly to other functional response analyses to better capture intrapatient dependencies and characterize personalized functional damage.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology Biology Physics-
dc.titleModeling Patient-Specific Dose-Function Response for Enhanced Characterization of Personalized Functional Damage-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2018.05.049-
dc.identifier.pmid30108006-
dc.identifier.scopuseid_2-s2.0-85051368373-
dc.identifier.volume102-
dc.identifier.issue4-
dc.identifier.spage1265-
dc.identifier.epage1275-
dc.identifier.eissn1879-355X-
dc.identifier.isiWOS:000447789700071-

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