Physics in medicine and biology
-
Knowledge of accurate parameter estimates is essential for incorporating normal tissue complication probability (NTCP) models into biologically based treatment planning. The purpose of this work is to derive parameter estimates for the Lyman-Kutcher-Burman (LKB) NTCP model using a combined analysis of multi-institutional toxicity data for the lung (radiation pneumonitis) and parotid gland (xerostomia). A series of published clinical datasets describing dose response for radiation pneumonitis (RP) and xerostomia were identified for this analysis. ⋯ For xerostomia expressed as reduction in stimulated salivary flow below 25% within six months after radiotherapy, the following values were obtained: m = 0.53 (95% CI 0.45, 0.65) and TD(50) = 31.4 Gy (95% CI 29.1, 34.0). Although a large number of parameter estimates for different NTCP models and critical structures exist and continue to appear in the literature, it is hard to justify the use of any single parameter set obtained at a selected institution for the purposes of biologically based treatment planning. Our expectation is that the proposed model parameters based on cumulative experience at various institutions are more representative of the overall practice of radiation therapy than any single-institution data, and could be more readily incorporated into clinical use.
-
Parametric imaging using the Patlak graphical method has been widely used to analyze dynamic PET data. Conventionally a Patlak parametric image is generated by reconstructing a sequence of dynamic images first and then performing Patlak graphical analysis on the time-activity curves pixel-by-pixel. However, because it is rather difficult to model the noise distribution in reconstructed images, the spatially variant noise correlation is simply ignored in the Patlak analysis, which leads to sub-optimal results. ⋯ We conduct computer simulations to validate the proposed direct method. Comparisons with the conventional indirect approach show that the proposed method results in a more accurate estimate of the parametric image. The proposed method has been applied to dynamic fully 3D PET data from a microPET scanner.