ArticleJournal of radiation research2026
Development of a spatially indexed dose-volume histogram for treatment plan evaluation.
Article in Journal of radiation research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Conventional dose-volume histograms (DVHs) lack spatial information, a critical limitation in evaluating carotid artery sparing in laryngeal volumetric-modulated arc therapy (VMAT). We developed a spatially indexed DVH that integrates the distance between the planning target volume (PTV) and carotid arteries for a more comprehensive plan quality assessment. Three representative cases (distant, intermediate, proximal) were analyzed. For each carotid voxel, dose and minimum Euclidean distance to the PTV were calculated. A color-coded cumulative DVH was generated by mapping the mean dose-specific distance (MDD) to a color gradient (red: proximal, blue: distal). Spatial metrics at 35 Gy were derived: minimum distance (dmin,35Gy), mean dose-specific distance (MD35Gy) and V35Gy,10mm (volume ≥35 Gy within 10 mm of PTV surface). The spatially indexed DVH visually identified spatial risk transitions. In the distant case, V35Gy,10mm was negligible (0.1 cc and N/A). In the intermediate case, despite a low conventional V35Gy (0.9 and 1.8 cc), proximity metrics revealed high-risk areas with a dmin,35Gy of 3.2 mm and V35Gy,10mm of 0.8 and 1.4 cc. The proximal case showed the highest risk, with the DVH shifting to red above 30 Gy; nearly all V35Gy (2.4 and 2.3 cc) was within the 10-mm high-risk zone (V35Gy,10mm: 2.0 and 1.7 cc), with a dmin,35Gy of 2.2 and 1.4 mm. The spatially indexed DVH provides an intuitive method to evaluate the spatial relationship between high-dose regions and the PTV, facilitating better risk stratification and optimization in laryngeal VMAT.
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