Radiobiological model-based bio-anatomical quality assurance in intensity-modulated radiation therapy for prostate cancer

Ji Yeon Park, Jeong Woo Lee, Jin Beom Chung, Kyoung Sik Choi, Yon Lae Kim, Byung Moon Park, Youhyun Kim, Jungmin Kim, Jonghak Choi, Jae Sung Kim, Semie Hong, Tae Suk Suh

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


A bio-anatomical quality assurance (QA) method employing tumor control probability (TCP) and normal tissue complication probability (NTCP) is described that can integrate radiobiological effects into intensity-modulated radiation therapy (IMRT). We evaluated the variations in the radiobiological effects caused by random errors (r-errors) and systematic errors (s-errors) by evaluating TCP and NTCP in two groups: patients with an intact prostate (G intact) and those who have undergone prostatectomy (G tectomy). The r-errors were generated using an isocenter shift of ±1 mm to simulate a misaligned patient set-up. The s-errors were generated using individual leaves that were displaced inwardly and outwardly by 1 mm on multileaf collimator field files. Subvolume-based TCP and NTCP were visualized on computed tomography (CT) images to determine the radiobiological effects on the principal structures. The bio-anatomical QA using the TCP and NTCP maps differentiated the critical radiobiological effects on specific volumes, particularly at the anterior rectal walls and planning target volumes. The s-errors showed a TCP variation of -40-25 in Gtectomy and -30-10 in Gintact, while the r-errors were less than 1.5 in both groups. The r-errors for the rectum and bladder showed higher NTCP variations at ±20 and ±10, respectively, and the s-errors were greater than ±65 for both. This bio-anatomical method, as a patient-specific IMRT QA, can provide distinct indications of clinically significant radiobiological effects beyond the minimization of probable physical dose errors in phantoms.

Original languageEnglish
Pages (from-to)978-988
Number of pages11
JournalJournal of Radiation Research
Issue number6
Publication statusPublished - 2012 Nov


  • Bio-anatomical quality assurance
  • intensity-modulated radiation therapy
  • normal tissue complication probability
  • prostate cancer
  • tumor control probability

ASJC Scopus subject areas

  • Radiation
  • Radiology Nuclear Medicine and imaging
  • Health, Toxicology and Mutagenesis


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