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El Naqa, Issam

Publications and source records attributed to El Naqa, Issam.

Integrating Multiomics Information in Deep Learning Architectures for Joint Actuarial Outcome Prediction in Non-Small Cell Lung Cancer Patients After Radiation Therapy

Novel actuarial deep learning neural network (ADNN) architectures are proposed for joint prediction of radiation therapy outcomes—radiation pneumonitis (RP) and local control (LC)—in stage III non-small cell lung cancer (NSCLC) patients. Unlike normal tissue complication probability/tumor control probability models that use dosimetric information solely, our proposed models consider complex interactions among multiomics information including positron emission tomography (PET) radiomics, cytokines, and miRNAs. Additional time-to-event information is also used in the actuarial prediction.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Modeling of Tumor Control Probability in Stereotactic Body Radiation Therapy for Adrenal Tumors

Stereotactic body radiation therapy (SBRT) in the management of adrenal metastases is emerging as a well-tolerated, effective method of treatment for patients with limited metastatic disease. SBRT planning and treatment utilization are widely variable, and publications report heterogeneous radiation dose fractionation schemes and treatment outcomes. The objective of this analysis was to review the current literature on SBRT for adrenal metastases and to develop treatment guidelines and a model for tumor control probability of SBRT for adrenal metastases based on these publications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A Primer on Dose-Response Data Modeling in Radiation Therapy

An overview of common approaches used to assess a dose response for radiation therapy–associated endpoints is presented, using lung toxicity data sets analyzed as a part of the High Dose per Fraction, Hypofractionated Treatment Effects in the Clinic effort as an example. Each component presented (eg, data-driven analysis, dose-response analysis, and calculating uncertainties on model prediction) is addressed using established approaches. Specifically, the maximum likelihood method was used to calculate best parameter values of the commonly used logistic model, the profile-likelihood to calculate confidence intervals on model parameters, and the likelihood ratio to determine whether the observed data fit is statistically significant. The bootstrap method was used to calculate confidence intervals for model predictions. Correlated behavior of model parameters and implication for interpreting dose response are discussed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Application of radiochromic gel dosimetry to commissioning of a megavoltage research linear accelerator for small–field animal irradiation studies

To develop and implement an efficient and accurate commissioning procedure for small-field static beam animal irradiation studies on an MV research linear accelerator (Linatron-M9) using radiochromic gel dosimetry. The research linear accelerator (Linatron-M9) is a 9 MV linac with a static fixed collimator opening of 5.08 cm diameter. Lead collimators were manually placed to create smaller fields of 2 × 2 cm 2 , 1 × 1 cm 2 , and 0.5 × 0.5 cm 2 . Relative dosimetry measurements were performed, including profiles, percent depth dose (PDD) curves, beam divergence, and relative output factors using various dosimetry tools, including a small volume ionization chamber (A14), GAFCHROMIC™ EBT3 film, and Clearview gel dosimeters. The gel dosimeter was used to provide a 3D volumetric reference of the irradiated fields. The Linatron profiles and relative output factors were extracted at a reference depth of 2 cm with the output factor measured relative to the 2 × 2 cm 2 reference field. Absolute dosimetry was performed using A14 ionization chamber measurements, which were verified using a national standards laboratory remote dosimetry service. Absolute dosimetry measurements were confirmed within 1.4% (k = 2, 95% confidence = 5%). The relative output factor of the small fields measured with films and gels agreed with a maximum relative percent error difference between the two methods of 1.1 % for the 1 × 1 cm 2 field and 4.3 % for the 0.5 × 0.5 cm 2 field. These relative errors were primarily due to the variability in the collimator positioning. The measured beam profiles demonstrated excellent agreement for beam size (measured as FWHM), within approximately 0.8 mm (or less). Film measurements were more accurate in the penumbra region due to the film’s finer resolution compared with the gel dosimeter. Following the van Dyk criteria, the PDD values of the film and gel measurements agree within 11% in the buildup region starting from 0.5 cm depth and within 2.6 % beyond maximum dose and into the fall-off region for depths up to 5 cm. The 2D beam profile isodose lines agree within 0.5 mm in all regions for the 0.5 × 0.5 cm 2 and the 1 × 1 cm 2 fields and within 1 mm for the larger field of 2 × 2 cm 2 . The 2D PDD curves agree within approximately 2% of the maximum in the typical therapy region (1–4 cm) for the 1 × 1 cm 2 and 2 × 2 cm 2 and within 5% for the 0.5 × 0.5 cm 2 field. This work provides a commissioning process to measure the beam characteristics of a fixed beam MV accelerator with detailed dosimetric evaluation for its implementation in megavoltage small animal irradiation studies. Radiochromic gel dosimeters are efficient small-field relative dosimetry tools providing 3D dose measurements allowing for full representation of dose, dosimeter misalignment corrections and high reproducibility with low inter-dosimeter variability. Altogether, radiochromic gels are valuable for fast, full relative dosimetry commissioning in comparison to films for application in high-energy small-field animal irradiation studies.

62 RADIOLOGY AND NUCLEAR MEDICINE↗