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Dose-volume histograms
R E Drzymala1, R Mohan, L Brewster
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
Summary
Dose-volume histograms (DVHs) graphically summarize radiation distribution for treatment plans. While useful for comparing plans and estimating outcomes, DVHs lack positional information and shouldn't be the sole evaluation criterion.
Area of Science:
- Medical Physics
- Radiation Oncology
- Radiotherapy Planning
Background:
- Dose-volume histograms (DVHs) graphically represent radiation dose distribution in patient treatment volumes.
- DVHs aid in comparing radiation treatment plans by showing dose uniformity and identifying hot spots in normal tissues.
Purpose of the Study:
- To discuss the methodology for generating and plotting DVHs.
- To highlight the caveats and limitations of DVH use in radiation therapy.
- To present general experiences from four hospitals utilizing DVHs.
Main Methods:
- Graphical representation of cumulative dose-volume frequency distributions.
- Analysis of DVH utility in comparing treatment plans and estimating TCP/NTCP.
- Discussion of DVH generation methodology and limitations.
Main Results:
- DVHs are valuable for visualizing dose distribution and comparing treatment plans.
- DVHs can serve as input for Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) calculations.
- Positional information loss is a key limitation of DVHs, necessitating their use with other evaluation criteria.
Conclusions:
- Accurate DVH computation is crucial due to the sensitivity of TCP and NTCP calculations to DVH shape.
- DVHs are a promising tool but should not be the sole criterion for evaluating radiation treatment plans.
- Experience from multiple institutions highlights the practical application and limitations of DVHs in radiotherapy.