Abstract
Introduction: A biologically adaptive radiation treatment method to maximize the TCP is shown. Functional imaging is used to acquire a heterogeneous dose prescription in terms of Dose Painting by Numbers and to create a patient-specific IMRT plan. Method and Materials: Adapted from a method for selective dose escalation under the guidance of spatial biology distribution, a model, which translates ...
Abstract
Introduction: A biologically adaptive radiation treatment method to maximize the TCP is shown. Functional imaging is used to acquire a heterogeneous dose prescription in terms of Dose Painting by Numbers and to create a patient-specific IMRT plan. Method and Materials: Adapted from a method for selective dose escalation under the guidance of spatial biology distribution, a model, which translates heterogeneously distributed radiobiological parameters into voxelwise dose prescriptions, was developed. At the example of a prostate case with F-18-choline PET imaging, different sets of reported values for the parameters were examined concerning their resulting range of dose values. Furthemore, the influence of each parameter of the linear-quadratic model was investigated. A correlation between PET signal and proliferation as well as cell density was assumed. Using our in-house treatment planning software Direct Monte Carlo Optimization (DMCO), a treatment plan based on the obtained dose prescription was generated. Gafchromic EBT films were irradiated for evaluation. Results: When a TCP of 95% was aimed at, the maximal dose in a voxel of the prescription exceeded 100 Gy for most considered parameter sets. One of the parameter sets resulted in a dose range of 87.1 Gy to 99.3 Gy, yielding a TCP of 94.7%, and was investigated more closely. The TCP of the plan decreased to 73.5% after optimization based on that prescription. The dose difference histogram of optimized and prescribed dose revealed a mean of -1.64 Gy and a standard deviation of 4.02 Gy. Film verification showed a reasonable agreement of planned and delivered dose. Conclusion: If the distribution of radiobiological parameters within a tumor is known, this model can be used to create a dose-painting by numbers plan which maximizes the TCP. It could be shown, that such a heterogeneous dose distribution is technically feasible.
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