Study of the Conformity Degree of Treatment Plans Using the Receiver Operating Characteristics Analysis

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Over the past decades computer-assisted treatment planning has permitted treatments to be tailored to the individual's problem and has allowed the user to easily explore several treatment plans in order to select the best one. We need some criteria that simplify the choice of the most conformal treatment plan. The aim of this paper is to examine the usefulness of the receiver operating characteristic (ROC) analysis using dose-volume histogram data to evaluate the conformity degree of a stereotactic treatment plan, as well as to propose a reference isodose. We define two actions for an irradiation and then we define the ROC dose-volume parameters (the sensitivity, the specificity, the Youden Index, the positive and the negative likelihood ratio) to quantify the impact of the two actions on the lesion and the healthy tissue. Using some of these parameters, we construct the ROC curve. Then we present three technniques to determine the optimum reference isodose (RI) for a given treatment plan. We applied this ROC analysis to 20 arteriovenous malformations previously treated by our stereotactic group. The results showed that ROC analysis is able to evaluate the conformity of a treatment plan as well as to propose an RI that sufficiently envelops the lesion while sparing the healthy tissue.

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