Finite Element-Based Personalized Simulation of Duodenal Hydrogel Spacer: Spacer Location Dependent Duodenal Sparing and a Decision Support System for Spacer-Enabled Pancreatic Cancer Radiation Therapy.
Finite Element-Based Personalized Simulation of Duodenal Hydrogel Spacer: Spacer Location Dependent Duodenal Sparing and a Decision Support System for Spacer-Enabled Pancreatic Cancer Radiation Therapy.
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DOI：
10.3389/fonc.2022.833231
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发表时间：
2022
影响因子：
4.7
通讯作者：
Ding K
中科院分区：
文献类型：
--
作者：
Hooshangnejad H;Youssefian S;Narang A;Shin EJ;Rao AD;Han-Oh S;McNutt T;Lee J;Hu C;Wong J;Ding K
胰腺癌是癌症相关死亡的第四大原因，5年总生存率（OS）非常低。放射治疗（RT）联合剂量递增显著增加了2年和3年的OS。然而，由于靠近十二指肠，剂量递增非常有限。水凝胶间隔器是减少十二指肠毒性的有效方法，但解剖结构和手术的复杂性使得间隔器手术的成功和有效性高度不确定。为了提供水凝胶椎间融合器的术前模拟，我们提出了一种患者特定的椎间融合器模拟器算法，并将其用于创建决策支持系统（DSS），以提供术前最佳椎间融合器位置，从而最大限度地发挥椎间融合器的优势。我们的研究分为三个阶段。在验证阶段，我们使用骰子相似系数（DSC）、重叠体积直方图（OVH）和径向最近邻距离（RNND）评价了十二指肠间隔区的患者特异性间隔区模拟器算法（FEMOSSA）。在模拟阶段，我们根据间隔器在十二指肠旁空间中的位置模拟了四种虚拟间隔器场景。接下来，设计立体定向体部放射治疗（SBRT）计划并进行剂量学分析。最后，在预测阶段，使用模拟阶段的结果，我们创建了一个贝叶斯决策支持系统来预测最佳的间隔位置和生物有效剂量（BED）。实现了融合器的真实模拟，反映在模拟融合器的平均目标和十二指肠DSC的统计学显著增加。此外，平均值和第5百分位数RNDs（0.5和2.1 mm）以及OVH阈值（平均值小于0.75 mm）的微小差异表明，模拟获得了与真实的间隔器相似的分离。我们发现，在十二指肠V20 Gy，高度空间位置依赖性的变化V33 Gy，和L1cc和V33 Gy之间的强相关性的空间位置无关的减少。最后，贝叶斯决策支持系统预测床的变化，均方根误差为3.6 Gys。研制了十二指肠间隔器模拟平台，并利用该平台系统研究了间隔器位置的剂量学效应。此外，L1cc是一种信息解剖反馈，用于指导DSS指示融合器功效、最佳位置和预期改善。
Pancreatic cancer is the fourth leading cause of cancer-related death, with a very low 5-year overall survival rate (OS). Radiation therapy (RT) together with dose escalation significantly increases the OS at 2 and 3 years. However, dose escalation is very limited due to the proximity of the duodenum. Hydrogel spacers are an effective way to reduce duodenal toxicity, but the complexity of the anatomy and the procedure makes the success and effectiveness of the spacer procedure highly uncertain. To provide a preoperative simulation of hydrogel spacers, we presented a patient-specific spacer simulator algorithm and used it to create a decision support system (DSS) to provide a preoperative optimal spacer location to maximize the spacer benefits. Our study was divided into three phases. In the validation phase, we evaluated the patient-specific spacer simulator algorithm (FEMOSSA) for the duodenal spacer using the dice similarity coefficient (DSC), overlap volume histogram (OVH), and radial nearest neighbor distance (RNND). For the simulation phase, we simulated four virtual spacer scenarios based on the location of the spacer in para-duodenal space. Next, stereotactic body radiation therapy (SBRT) plans were designed and dosimetrically analyzed. Finally, in the prediction phase, using the result of the simulation phase, we created a Bayesian DSS to predict the optimal spacer location and biological effective dose (BED). A realistic simulation of the spacer was achieved, reflected in a statistically significant increase in average target and duodenal DSC for the simulated spacer. Moreover, the small difference in average mean and 5th-percentile RNNDs (0.5 and 2.1 mm) and OVH thresholds (average of less than 0.75 mm) showed that the simulation attained similar separation as the real spacer. We found a spacer-location-independent decrease in duodenal V20Gy, a highly spacer-location-dependent change in V33Gy, and a strong correlation between L1cc and V33Gy. Finally, the Bayesian DSS predicted the change in BED with a root mean squared error of 3.6 Gys. A duodenal spacer simulator platform was developed and used to systematically study the dosimetric effect of spacer location. Further, L1cc is an informative anatomical feedback to guide the DSS to indicate the spacer efficacy, optimum location, and expected improvement.
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用于胰腺癌放射治疗的可生物降解水凝胶垫片保留十二指肠的剂量预测模型
DOI：
10.1016/j.ijrobp.2018.07.184
发表时间：
2018-11-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Feng Z;Rao AD;Cheng Z;Shin EJ;Moore J;Su L;Kim SH;Wong J;Narang A;Herman JM;McNutt T;Li D;Ding K
通讯作者：
Ding K
影响因子：
3.8
作者：
Hooshangnejad, Hamed;Youssefian, Sina;Ding, Kai
通讯作者：
Ding, Kai
在尸体模型中进行 EUS 引导的水凝胶微粒注射。
影响因子：
2.1
作者：
Kim SH;Ding K;Rao A;He J;Bhutani MS;Herman JM;Narang A;Shin EJ
通讯作者：
Shin EJ
DOI：
10.1016/j.ijrobp.2015.12.003
发表时间：
2016-03-15
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Krishnan S;Chadha AS;Suh Y;Chen HC;Rao A;Das P;Minsky BD;Mahmood U;Delclos ME;Sawakuchi GO;Beddar S;Katz MH;Fleming JB;Javle MM;Varadhachary GR;Wolff RA;Crane CH
通讯作者：
Crane CH
影响因子：
2.3
作者：
Hassanzadeh C;Rudra S;Bommireddy A;Hawkins WG;Wang-Gillam A;Fields RC;Cai B;Park J;Green O;Roach M;Henke L;Kim H
通讯作者：
Kim H