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On the radiobiological impact of metal artifacts in head-and-neck IMRT in terms of tumor control probability (TCP) and normal tissue complication probability (NTCP)

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Abstract

To investigate the effects of distorted head-and-neck (H&N) intensity-modulated radiation therapy (IMRT) dose distributions (hot and cold spots) on normal tissue complication probability (NTCP) and tumor control probability (TCP) due to dental-metal artifacts. Five patients’ IMRT treatment plans have been analyzed, employing five different planning image data-sets: (a) uncorrected (UC); (b) homogeneous uncorrected (HUC); (c) sinogram completion corrected (SCC); (d) minimum-value-corrected (MVC); and (e) streak-artifact-reduction including minimum-value-correction (SAR-MVC), which has been taken as the reference data-set. The effects on NTCP and TCP were evaluated using the Lyman-NTCP model and the Logistic-TCP model, respectively. When compared to the predicted NTCP obtained using the reference data-set, the treatment plan based on the original CT data-set (UC) yielded an increase in NTCP of 3.2 and 2.0% for the spared parotid gland and the spinal cord, respectively. While for the treatment plans based on the MVC CT data-set the NTCP increased by a 1.1% and a 0.1% for the spared parotid glands and the spinal cord, respectively. In addition, the MVC correction method showed a reduction in TCP for target volumes (MVC: ΔTCP = −0.6% vs. UC: ΔTCP = -1.9%) with respect to that of the reference CT data-set. Our results indicate that the presence of dental-metal-artifacts in H&N planning CT data-sets has an impact on the estimates of TCP and NTCP. In particular dental-metal-artifacts lead to an increase in NTCP for the spared parotid glands and a slight decrease in TCP for target volumes.

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Acknowledgments

This work was partially supported by a research grant for Philips Radiation Oncology Systems.

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Authors and Affiliations

  1. Department of Medical Physics, University of Wisconsin, Madison, USA

    Yusung Kim & Wolfgang A. Tomé

  2. Department of Human Oncology, University of Wisconsin Medical School, K4/344 CSC, 600 Highland Ave, Madison, WI, 53792, USA

    Wolfgang A. Tomé

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  1. Yusung Kim
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  2. Wolfgang A. Tomé
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Correspondence to Wolfgang A. Tomé.

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Kim, Y., Tomé, W.A. On the radiobiological impact of metal artifacts in head-and-neck IMRT in terms of tumor control probability (TCP) and normal tissue complication probability (NTCP). Med Bio Eng Comput 45, 1045–1051 (2007). https://doi.org/10.1007/s11517-007-0196-8

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  • DOI: https://doi.org/10.1007/s11517-007-0196-8

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