New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy
Background and purpose: Growing evidence suggests that spatial dose variations across the rectal surface influence toxicity risk after radiotherapy. Existing methodologies employ a fixed, arbitrary physical extent for rectal dose mapping, limiting their analysis. We developed a method to standardise...
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Elsevier
2025-01-01
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| Series: | Physics and Imaging in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631625000065 |
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| author | Artemis Bouzaki Dylan Green Marcel van Herk Jane Shortall Tanuj Puri Sarah Kerns David Azria Marrie-Pierre Farcy-Jacquet Jenny Chang-Claude Ananya Choudhury Alison Dunning Maarten Lambrecht Barbara Avuzzi Dirk De Ruysscher Petra Seibold Elena Sperk Christopher Talbot Ana Vega Liv Veldeman Adam Webb Barry Rosenstein Catharine M. West Eliana Gioscio Tiziana Rancati Eliana Vasquez Osorio Alan McWilliam |
| author_facet | Artemis Bouzaki Dylan Green Marcel van Herk Jane Shortall Tanuj Puri Sarah Kerns David Azria Marrie-Pierre Farcy-Jacquet Jenny Chang-Claude Ananya Choudhury Alison Dunning Maarten Lambrecht Barbara Avuzzi Dirk De Ruysscher Petra Seibold Elena Sperk Christopher Talbot Ana Vega Liv Veldeman Adam Webb Barry Rosenstein Catharine M. West Eliana Gioscio Tiziana Rancati Eliana Vasquez Osorio Alan McWilliam |
| author_sort | Artemis Bouzaki |
| collection | DOAJ |
| description | Background and purpose: Growing evidence suggests that spatial dose variations across the rectal surface influence toxicity risk after radiotherapy. Existing methodologies employ a fixed, arbitrary physical extent for rectal dose mapping, limiting their analysis. We developed a method to standardise rectum contours, unfold them into 2D cylindrical surface maps, and identify subregions where higher doses increase rectal toxicities. Materials and methods: Data of 1,048 patients with prostate cancer from the REQUITE study were used. Deep learning based automatic segmentations were generated to ensure consistency. Rectum length was standardised using linear transformations superior and inferior to the prostate. The automatic contours were validated against the manual contours through contour variation assessment with cylindrical mapping. Voxel-based analysis of the dose surface maps for the manual and automatic contours against individual rectal toxicities was performed using Student’s t permutation test and Cox Proportional Hazards Model (CPHM). Significance was defined by permutation testing. Results: Our method enabled the analysis of 1,048 patients using automatic segmentation. Student’s t-test showed significance (p < 0.05) in the lower posterior for clinical-reported proctitis and patient-reported bowel urgency. Univariable CPHM identified a 3 % increased risk per Gy for clinician-reported proctitis and a 2 % increased risk per Gy for patient-reported bowel urgency in the lower posterior. No other endpoints were significant. Conclusion: We developed a methodology that unfolds the rectum to a 2D surface map. The lower posterior was significant for clinician-reported proctitis and patient-reported bowel urgency, suggesting that reducing the dose in the region could decrease toxicity risk. |
| format | Article |
| id | doaj-art-80b77c9e11ca441991c90cd1aae42bfe |
| institution | Kabale University |
| issn | 2405-6316 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj-art-80b77c9e11ca441991c90cd1aae42bfe2025-01-26T05:04:13ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162025-01-0133100701New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapyArtemis Bouzaki0Dylan Green1Marcel van Herk2Jane Shortall3Tanuj Puri4Sarah Kerns5David Azria6Marrie-Pierre Farcy-Jacquet7Jenny Chang-Claude8Ananya Choudhury9Alison Dunning10Maarten Lambrecht11Barbara Avuzzi12Dirk De Ruysscher13Petra Seibold14Elena Sperk15Christopher Talbot16Ana Vega17Liv Veldeman18Adam Webb19Barry Rosenstein20Catharine M. West21Eliana Gioscio22Tiziana Rancati23Eliana Vasquez Osorio24Alan McWilliam25Division of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; Corresponding author at: The University of Manchester, The Paterson, first floor, Wilmslow Road, Manchester, M16 7QS, the United Kingdom of Great Britain and Northern Ireland.Department of Engineering Science, University of Oxford, Oxford, the United Kingdom of Great Britain and Northern IrelandDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern IrelandMedical College of Wisconsin, Milwaukee, WI, USAFederation Universitaire d’Oncologie Radiothérapie d’Occitanie Méditerranée, Univ Montpellier, INSERM U1194 IRCM, Institut du Cancer Montpellier (ICM), Montpellier, FranceFederation Universitaire d’Oncologie Radiothérapie d’Occitanie Méditerranée, Institut du Cancer Du Gard (ICG), CHU Carémeau, Nîmes, FranceGerman Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, GermanyDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandCentre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge, the United Kingdom of Great Britain and Northern IrelandKU Leuven, Leuven, BelgiumDepartment of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDepartment of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW School, Maastricht, the NetherlandsGerman Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, GermanyDepartment of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, GermanyDepartment of Genetics & Cancer Sciences, University of Leicester, the United Kingdom of Great Britain and Northern IrelandInstituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica (FPGMX), Santiago de Compostela, Spain; Biomedical Network on Rare Diseases (CIBERER), SpainGhent University Hospital, Belgium; Ghent University, Ghent, BelgiumDepartment of Genetics & Cancer Sciences, University of Leicester, the United Kingdom of Great Britain and Northern IrelandDepartments of Radiation Oncology & Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, NY, USATranslational Radiobiology Group, Division of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandData Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyData Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandDivision of Cancer Sciences, University of Manchester, Manchester, the United Kingdom of Great Britain and Northern Ireland; The Christie NHS Foundation Trust, Manchester, the United Kingdom of Great Britain and Northern IrelandBackground and purpose: Growing evidence suggests that spatial dose variations across the rectal surface influence toxicity risk after radiotherapy. Existing methodologies employ a fixed, arbitrary physical extent for rectal dose mapping, limiting their analysis. We developed a method to standardise rectum contours, unfold them into 2D cylindrical surface maps, and identify subregions where higher doses increase rectal toxicities. Materials and methods: Data of 1,048 patients with prostate cancer from the REQUITE study were used. Deep learning based automatic segmentations were generated to ensure consistency. Rectum length was standardised using linear transformations superior and inferior to the prostate. The automatic contours were validated against the manual contours through contour variation assessment with cylindrical mapping. Voxel-based analysis of the dose surface maps for the manual and automatic contours against individual rectal toxicities was performed using Student’s t permutation test and Cox Proportional Hazards Model (CPHM). Significance was defined by permutation testing. Results: Our method enabled the analysis of 1,048 patients using automatic segmentation. Student’s t-test showed significance (p < 0.05) in the lower posterior for clinical-reported proctitis and patient-reported bowel urgency. Univariable CPHM identified a 3 % increased risk per Gy for clinician-reported proctitis and a 2 % increased risk per Gy for patient-reported bowel urgency in the lower posterior. No other endpoints were significant. Conclusion: We developed a methodology that unfolds the rectum to a 2D surface map. The lower posterior was significant for clinician-reported proctitis and patient-reported bowel urgency, suggesting that reducing the dose in the region could decrease toxicity risk.http://www.sciencedirect.com/science/article/pii/S2405631625000065RadiotherapyProstate cancerNormal tissue toxicityDose surface mapRectum mapping |
| spellingShingle | Artemis Bouzaki Dylan Green Marcel van Herk Jane Shortall Tanuj Puri Sarah Kerns David Azria Marrie-Pierre Farcy-Jacquet Jenny Chang-Claude Ananya Choudhury Alison Dunning Maarten Lambrecht Barbara Avuzzi Dirk De Ruysscher Petra Seibold Elena Sperk Christopher Talbot Ana Vega Liv Veldeman Adam Webb Barry Rosenstein Catharine M. West Eliana Gioscio Tiziana Rancati Eliana Vasquez Osorio Alan McWilliam New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy Physics and Imaging in Radiation Oncology Radiotherapy Prostate cancer Normal tissue toxicity Dose surface map Rectum mapping |
| title | New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| title_full | New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| title_fullStr | New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| title_full_unstemmed | New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| title_short | New rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| title_sort | new rectum dose surface mapping methodology to identify rectal subregions associated with toxicities following prostate cancer radiotherapy |
| topic | Radiotherapy Prostate cancer Normal tissue toxicity Dose surface map Rectum mapping |
| url | http://www.sciencedirect.com/science/article/pii/S2405631625000065 |
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