Dose surface maps of the heart can identify regions associated with worse survival for lung cancer patients treated with radiotherapy

Autor: Alan McWilliam, Chloe Dootson, Lewis Graham, Kathryn Banfill, Azadeh Abravan, Marcel van Herk
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Physics and Imaging in Radiation Oncology, Vol 15, Iss , Pp 46-51 (2020)
Druh dokumentu: article
ISSN: 2405-6316
DOI: 10.1016/j.phro.2020.07.002
Popis: Background and purpose: For lung cancer patients treated with radiotherapy, radiation dose to the heart has been associated with overall survival, with volumetric dose statistics widely presented. However, critical cardiac structures are present on the hearts surface, where this approach may be sub-optimal. In this work we present a methodology for creating cardiac surface dose maps and identify regions where excess dose is associated with in worse overall survival. Material and methods: A modified cylindrical coordinate system was implemented to map the cardiac surface dose for lung cancer patients. Validation was performed by mapping the cardiac chambers for 55 patients, fitting a point spread function (PSF) to the blurred edge. To account for this uncertainty, dose maps were blurred by a 2D-Gaussian with width described by the PSF. Permutation testing identified regions where excess dose was associated with worse patient survival. The 99th percentile of the max t-value then defined a cardiac surface region to extract dose, from each patient, to be analysed in a multivariable cox-proportional hazards survival model. Results: Cardiac surface maps were created for 648 lung cancer patients. Cardiac surface dose maps were blurred with a 2D- Gaussian filter of size σφ = 4.3° and σy = 1.3units to account for mapping uncertainties. Permutation testing identified significant differences across the surface of the right atria, p
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