Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients

Abstract The risk of radiation-induced toxicity in patients treated for head and neck (HN) cancer with radiation therapy (RT) is traditionally estimated by condensing the 3D dose distribution into a monodimensional cumulative dose-volume histogram which disregards information on dose localization. W...

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Autores principales:	Serena Monti, Giuseppe Palma, Vittoria D’Avino, Marianna Gerardi, Giulia Marvaso, Delia Ciardo, Roberto Pacelli, Barbara A. Jereczek-Fossa, Daniela Alterio, Laura Cella
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5b3627dfa4f44ddf9c10181fe781d041
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spelling	oai:doaj.org-article:5b3627dfa4f44ddf9c10181fe781d0412021-12-02T15:04:55ZVoxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients10.1038/s41598-017-07586-x2045-2322https://doaj.org/article/5b3627dfa4f44ddf9c10181fe781d0412017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-07586-xhttps://doaj.org/toc/2045-2322Abstract The risk of radiation-induced toxicity in patients treated for head and neck (HN) cancer with radiation therapy (RT) is traditionally estimated by condensing the 3D dose distribution into a monodimensional cumulative dose-volume histogram which disregards information on dose localization. We hypothesized that a voxel-based approach would identify correlations between radiation-induced morbidity and local dose release, thus providing a new insight into spatial signature of radiation sensitivity in composite regions like the HN district. This methodology was applied to a cohort of HN cancer patients treated with RT at risk of radiation-induced acute dysphagia (RIAD). We implemented an inter-patient elastic image registration framework that proved robust enough to match even the most elusive HN structures and to provide accurate dose warping. A voxel-based statistical analysis was then performed to test regional dosimetric differences between patients with and without RIAD. We identified a significantly higher dose delivered to RIAD patients in two voxel clusters in correspondence of the cricopharyngeus muscle and cervical esophagus. Our study goes beyond the well-established organ-based philosophy exploring the relationship between radiation-induced morbidity and local dose differences in the HN region. This approach is generally applicable to different HN toxicity endpoints and is not specific to RIAD.Serena MontiGiuseppe PalmaVittoria D’AvinoMarianna GerardiGiulia MarvasoDelia CiardoRoberto PacelliBarbara A. Jereczek-FossaDaniela AlterioLaura CellaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Serena Monti Giuseppe Palma Vittoria D’Avino Marianna Gerardi Giulia Marvaso Delia Ciardo Roberto Pacelli Barbara A. Jereczek-Fossa Daniela Alterio Laura Cella Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
description	Abstract The risk of radiation-induced toxicity in patients treated for head and neck (HN) cancer with radiation therapy (RT) is traditionally estimated by condensing the 3D dose distribution into a monodimensional cumulative dose-volume histogram which disregards information on dose localization. We hypothesized that a voxel-based approach would identify correlations between radiation-induced morbidity and local dose release, thus providing a new insight into spatial signature of radiation sensitivity in composite regions like the HN district. This methodology was applied to a cohort of HN cancer patients treated with RT at risk of radiation-induced acute dysphagia (RIAD). We implemented an inter-patient elastic image registration framework that proved robust enough to match even the most elusive HN structures and to provide accurate dose warping. A voxel-based statistical analysis was then performed to test regional dosimetric differences between patients with and without RIAD. We identified a significantly higher dose delivered to RIAD patients in two voxel clusters in correspondence of the cricopharyngeus muscle and cervical esophagus. Our study goes beyond the well-established organ-based philosophy exploring the relationship between radiation-induced morbidity and local dose differences in the HN region. This approach is generally applicable to different HN toxicity endpoints and is not specific to RIAD.
format	article
author	Serena Monti Giuseppe Palma Vittoria D’Avino Marianna Gerardi Giulia Marvaso Delia Ciardo Roberto Pacelli Barbara A. Jereczek-Fossa Daniela Alterio Laura Cella
author_facet	Serena Monti Giuseppe Palma Vittoria D’Avino Marianna Gerardi Giulia Marvaso Delia Ciardo Roberto Pacelli Barbara A. Jereczek-Fossa Daniela Alterio Laura Cella
author_sort	Serena Monti
title	Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
title_short	Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
title_full	Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
title_fullStr	Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
title_full_unstemmed	Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
title_sort	voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/5b3627dfa4f44ddf9c10181fe781d041
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Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients

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