Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards Charles S. Mayo, PhD, John.

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Presentation transcript:

Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards Charles S. Mayo, PhD, John Yao, PhD, Avraham Eisbruch, MD, James M. Balter, PhD, Dale W. Litzenberg, PhD, Martha M. Matuszak, PhD, Marc L. Kessler, PhD, Grant Weyburn, BS, Carlos J. Anderson, PhD, Dawn Owen, MD, William C. Jackson, MD, Randall Ten Haken, PhD Advances in Radiation Oncology Volume 2, Issue 3, Pages 503-514 (July 2017) DOI: 10.1016/j.adro.2017.04.005 Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 1 Statistical dose-volume histogram (DVH) dashboard quantifies comparison of statistical metrics for the current plan (green) versus historical experience. Statistical DVH (center) compares the DVH curve to historical experience for the median (dashed line), 50% confidence interval (CI; dark pink), 70% CI (intermediate pink), and 90% CI light pink. Box-and-whisker plots compare plan level (left panel) and structure level (right panel) metrics. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 2 The use of the statistical dose-volume histogram (DVH) and metrics to compare DVH curves for patients with low and high weighted experience scores for uninvolved versus involved parotid. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 3 (A) Decomposition and comparison of 2 plans from the head and neck cohort. Two plans of different difficulty levels, overall plan generalized evaluation metrics (GEM) at the median (green plus) and 95% quantile (red diamond), are detailed by GEM scores of each threshold-priority constraint (missing data indicate structure not contoured in that plan). Box-and-whisker plots have their whiskers located at the 5% and 95% quantiles of the GEM scores. Their corresponding metric values are tabled in the right columns of metric quantiles. (B) Decomposition and comparison of 2 plans from the prostate cohort, with as low as reasonably achievable (ALARA) constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. For the Rectum:V75Gy[%] constraint, which has a median of 0 Gy, a small number of 0.1 is used as the threshold. (C) Decomposition and comparison of 2 plans from 5-fraction liver stereotactic body radiation therapy cohort, with ALARA constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 3 (A) Decomposition and comparison of 2 plans from the head and neck cohort. Two plans of different difficulty levels, overall plan generalized evaluation metrics (GEM) at the median (green plus) and 95% quantile (red diamond), are detailed by GEM scores of each threshold-priority constraint (missing data indicate structure not contoured in that plan). Box-and-whisker plots have their whiskers located at the 5% and 95% quantiles of the GEM scores. Their corresponding metric values are tabled in the right columns of metric quantiles. (B) Decomposition and comparison of 2 plans from the prostate cohort, with as low as reasonably achievable (ALARA) constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. For the Rectum:V75Gy[%] constraint, which has a median of 0 Gy, a small number of 0.1 is used as the threshold. (C) Decomposition and comparison of 2 plans from 5-fraction liver stereotactic body radiation therapy cohort, with ALARA constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 3 (A) Decomposition and comparison of 2 plans from the head and neck cohort. Two plans of different difficulty levels, overall plan generalized evaluation metrics (GEM) at the median (green plus) and 95% quantile (red diamond), are detailed by GEM scores of each threshold-priority constraint (missing data indicate structure not contoured in that plan). Box-and-whisker plots have their whiskers located at the 5% and 95% quantiles of the GEM scores. Their corresponding metric values are tabled in the right columns of metric quantiles. (B) Decomposition and comparison of 2 plans from the prostate cohort, with as low as reasonably achievable (ALARA) constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. For the Rectum:V75Gy[%] constraint, which has a median of 0 Gy, a small number of 0.1 is used as the threshold. (C) Decomposition and comparison of 2 plans from 5-fraction liver stereotactic body radiation therapy cohort, with ALARA constraints involved. ALARA thresholds (constraint values) are set to be the medians of their corresponding metric values, with an assigned priority of 4 and highlighted in blue. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 4 Comparison of statistical metrics for heart doses in a liver stereotactic body radiation therapy (SBRT) patient treated with 5 fractions. Generalized evaluation metric (GEM) and GEMpop calculations use 2 priority 1 constraint values D15cc (Gy) and D0.5cc (Gy). These increase faster than normal tissue complication probability, consistent with more conservative clinical practice. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions

Figure 5 Comparison of normal tissue complication probability, weighted experience score, generalized evaluation metric (GEM), and GEMpop scores versus mean dose for involved and uninvolved parotids. Advances in Radiation Oncology 2017 2, 503-514DOI: (10.1016/j.adro.2017.04.005) Copyright © 2017 The Authors on behalf of the American Society for Radiation Oncology Terms and Conditions