51. PACE: A Probabilistic Atlas for Normal Tissue Complication Estimation in Radiation Oncology
- Author
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Serena Monti, Amedeo Buonanno, Giuseppe Palma, Laura Cella, Roberto Pacelli, Palma, Giuseppe, Monti, Serena, Buonanno, Amedeo, Pacelli, Roberto, and Cella, Laura
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0301 basic medicine ,Cancer Research ,Computer science ,medicine.medical_treatment ,Normal tissue complication probability ,computer.software_genre ,Machine learning ,lcsh:RC254-282 ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Voxel ,Radiation oncology ,Covariate ,medicine ,Voxel-based analysi ,Original Research ,Pace ,business.industry ,Voxel-based analysis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiation therapy ,Radiation-induced morbidity ,030104 developmental biology ,Oncology ,Learning curve ,030220 oncology & carcinogenesis ,Artificial intelligence ,Radio-sensitivity ,Complication ,business ,computer - Abstract
In radiation oncology, the need for a modern Normal Tissue Complication Probability (NTCP) philosophy to include voxel-based evidence on organ radio-sensitivity (RS) has been acknowledged. Here a new formalism (Probabilistic Atlas for Complication Estimation, PACE) to predict radiation-induced morbidity (RIM) is presented. The adopted strategy basically consists in keeping the structure of a classical, phenomenological NTCP model, such as the Lyman-Kutcher-Burman (LKB), and replacing the dose distribution with a collection of RIM odds, including also significant non-dosimetric covariates, as input of the model framework. The theory was first demonstrated in silico on synthetic dose maps, classified according to synthetic outcomes. PACE was then applied to a clinical dataset of thoracic cancer patients classified for lung fibrosis. LKB models were trained for comparison. Overall, the obtained learning curves showed that the PACE model outperformed the LKB and predicted synthetic outcomes with an accuracy >0.8. On the real patients, PACE performance, evaluated by both discrimination and calibration, was significantly higher than LKB. This trend was confirmed by cross-validation. Furthermore, the capability to infer the spatial pattern of underlying RS map for the analyzed RIM was successfully demonstrated, thus paving the way to new perspectives of NTCP models as learning tools. more...
- Published
- 2019
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