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Incorporating biological modeling into patient-specific plan verification.

Ara N Alexandrian¹, Panayiotis Mavroidis², Ganesh Narayanasamy³

¹Department of Radiation Oncology, University of Texas Health Sciences Center, San Antonio, TX, USA.

Journal of Applied Clinical Medical Physics

|February 27, 2020

Summary

Biological modeling using dose-volume histograms (DVHs) can predict tumor control and normal tissue complications. This method offers enhanced pretreatment verification beyond standard gamma analysis in radiotherapy.

Keywords:

IMRT QA radiobiological QA radiobiological verification radiobiology

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Area of Science:

Medical Physics
Radiation Oncology
Radiotherapy Quality Assurance

Background:

Dose-volume histogram (DVH) measurements are integrated into quality assurance (QA) systems.
DVHs provide metrics for evaluating radiotherapy delivery accuracy, complementing gamma analysis.

Purpose of the Study:

To investigate if tumor control probability (TCP) and normal tissue complication probability (NTCP) calculations offer additional insights beyond conventional dose delivery verification.
To assess the utility of biological modeling for pretreatment estimation of TCP and NTCP.

Main Methods:

A commercial QA system generated DVHs from treatment plans using planning CT images and patient-specific QA measurements on a phantom.
Biological modeling was applied to DVHs from both the treatment planning system and the QA system.

Main Results:

Complication-free tumor control probability (P+) was calculated for intensity-modulated radiotherapy (IMRT) patients across various sites: brain, head-neck, lung, pelvis, and prostate.
Specific P+ values with associated uncertainties were reported for each anatomical site.

Conclusions:

Phantom-based dose measurements can predict pretreatment TCP and NTCP.
Biological modeling enhances pretreatment verification by providing deeper insights into radiotherapy delivery accuracy.