A tumour control probability model for radiotherapy of prostate cancer using magnetic resonance imaging-based apparent diffusion coefficient maps
A tumour control probability model for radiotherapy of prostate cancer using magnetic resonance imaging-based apparent diffusion coefficient maps
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DOI：
10.1016/j.radonc.2016.02.030
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发表时间：
2016-04-01
影响因子：
5.7
通讯作者：
Muren, Ludvig Paul
中科院分区：
文献类型：
--
作者：
Casares-Magaz, Oscar;van der Heide, Uulke A.;Muren, Ludvig Paul
背景和目的：标准肿瘤控制概率（TCP）模型假设肿瘤细胞密度均匀。本研究的目的是通过包括从多参数磁共振成像（MRI）和基于表观扩散系数（ADC）图的细胞密度分布提取的指标肿瘤区域来开发个体化TCP模型。应用一系列20名前列腺癌患者的ADC图来估计每个体素内细胞的初始数量，使用三种不同的方法来处理ADC值和细胞密度之间的关系：线性、二进制和S形关系。所有TCP模型均基于线性二次细胞存活曲线，假设α/β = 1.93戈伊（与最近的荟萃分析一致）和一组在35次分次向整个前列腺输送77戈伊时获得70%的TCP（α = 0.18戈伊（-1））。结果：总体而言，TCP曲线的ADC图的基础上显示更大的差异比那些假设均匀的细胞密度的个人。使用基于MRI的体素密度，整个患者队列中达到50% TCP所需的剂量范围为20.1戈伊、18.7戈伊和13.2戈伊（分别为线性、二元和乙状结肠方法），与使用恒定密度的4.1戈伊相比。结论：将肿瘤指数信息与基于ADC图的细胞密度一起纳入，用于前列腺癌RT的患者肿瘤反应分化，与基于均匀细胞密度的TCP曲线相比，在整个队列中，TCP曲线的D-50%范围更大。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: Standard tumour control probability (TCP) models assume uniform tumour cell density across the tumour. The aim of this study was to develop an individualised TCP model by including index-tumour regions extracted form multi-parametric magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) maps-based cell density distributions.Materials and methods: ADC maps in a series of 20 prostate cancer patients were applied to estimate the initial number of cells within each voxel, using three different approaches for the relation between ADC values and cell density: a linear, a binary and a sigmoid relation. All TCP models were based on linear quadratic cell survival curves assuming alpha/beta = 1.93 Gy (consistent with a recent meta-analysis) and a set to obtain a 70% of TCP when 77 Gy was delivered to the entire prostate in 35 fractions (alpha = 0.18 Gy(-1)).Results: Overall, TCP curves based on ADC maps showed larger differences between individuals than those assuming uniform cell densities. The range of the dose required to reach 50% TCP across the patient cohort was 20.1 Gy, 18.7 Gy and 13.2 Gy using an MRI-based voxel density (linear, binary and sigmoid approach, respectively), compared to 4.1 Gy using a constant density.Conclusions: Inclusion of tumour-index information together with ADC maps-based cell density increases inter-patient tumour response differentiation for use in prostate cancer RT, resulting in TCP curves with a larger range in D-50% across the cohort compared with those based on uniform cell densities. (C) 2016 Elsevier Ireland Ltd. All rights reserved.