3/22/2023 0 Comments Iise manuscript central![]() ![]() Some researchers proposed to segment the heart into anatomically-defined subsections using atlas and construct subsection-specific DVH ( van den Bogaard et al. However, most existing research on cardiac toxicity modeling is still based on DVH of the whole heart. This problem is more severe for cardiac toxicity modeling because the heart is a complicated organ and some subregions may be more susceptible to radiation damage than others. Various statistical models have been used, such as generalized linear models (GLM) ( Liu et al., 2019), neural networks ( Gulliford et al., 2010), and support vector machines ( Chen et al., 2007).Ī limitation of DVH-based NTCP models is the loss of spatial information of the 3-D dose distribution on the organ-at-risk. Commonly extracted features from DVH are V D, defined as the fractional volume of the organ receiving a dose level greater than D Gy, D = D min, …, D max. After a DVH is constructed, features can be extracted from the DVH and linked with treatment outcomes through statistical models. The latter plots the fractional volume of the organ-at-risk receiving a dose greater than or equal to D. The former plots the fractional volume of the organ-at-risk receiving a certain level of dose D, where D ranges from the smallest dose ( D min) to the largest dose ( D max) with a pre-specified bin size. There are two types of DVH, differential and cumulative DVH. DVH is a histogram that relates radiation dose to organ volume in RT planning. Most NTCP models are based on Dose-Volume-Histogram (DVH) ( Drzymala et al., 1991). NTCP models have been developed for various types of cancer such as prostate and lung cancer ( Gagliardi et al., 2010 Rose et al., 2009 Troeller et al., 2015). In the literature, the research that studies the impact of radiation on normal (non-cancerous) organs-at-risk is known as Normal Tissue Complication Probability (NTCP) modeling. This understanding can help optimize the treatment plan of each patient to reduce heart damage and optimize the treatment outcomes. There is an urgent need to better understand how treatment outcomes of lung cancer patients are affected by radiation dose spilled to the heart. This phenomenon is known as radiation-induced cardiac toxicity ( Belliere et al., 2009 Cella et al., 2014 Hardy et al., 2010). This may damage the heart, and thus deteriorating treatment outcomes and shortening the overall survival of patients. While a majority amount of the radiation dose in RT is delivered to the tumor in the lung, it is inevitable for a certain amount of dose to spill to nearby organs such as the heart. The most common treatment for lung cancer is radiation therapy (RT). The survival rate is even lower in the developing world ( Majumdar, 2009). In the U.S., around 15% patients survive beyond five years after diagnosis. Patients with lung cancer have a low survival rate. Lung cancer is a fatal disease that caused 150,000 deaths in year 2018 alone ( American Cancer Society, 2018). Our finding suggests that protective strategies may be developed to spare the TSSs, and thus helping RT planning achieve optimal results in treating lung cancer patients. Damage of the sinoatrial node by radiation toxicity disrupts the crucial function of the heart, leading to shortening of the overall survival. ![]() We apply the proposed method to a real-world dataset and find TSSs that harbor the sinoatrial node of the electronic conduction system of the heart. We propose a novel method that automatically searches for subregions of the heart that are susceptible to radiation toxicity, called Toxicity-Susceptible Subregions (TSSs), based on the 3-D dose distribution. However, despite the fact that dose distribution on the heart is 3-D, most existing research collapses the 3-D dose map into a 1-D histogram to be linked with outcomes. There is an urgent need to better understand how treatment outcomes are affected by radiation dose spilled to the heart in order to optimize RT planning. Because the lungs are close to the heart, radiation dose may inevitably spill to the heart, causing heart damage and diminishing treatment outcomes. Radiation therapy (RT) is a commonly used approach for treating lung cancer. ![]()
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