{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:27:37Z","timestamp":1770744457570,"version":"3.49.0"},"reference-count":65,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T00:00:00Z","timestamp":1602892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011676","name":"Elekta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011676","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Intratumoral dose response can be detected using serial fluoro\u20102\u2010deoxyglucose\u2010(FDG) positron emission tomography (PET)\/computed tomography (CT) imaging feedback during treatment and used to guide adaptive dose painting by number (DPbN). However, to reliably implement this technique, the effect of uncertainties in quantitative PET\/CT imaging feedback on tumor voxel dose\u2010response assessment and DPbN needs to be determined and reduced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three major uncertainties, induced by (a) PET imaging partial volume effect (PVE) and (b) tumor deformable image registration (DIR), and (c) variation of the time interval between FDG injection and PET image acquisition (TI), were determined using serial FDG\u2010PET\/CT images acquired during chemoradiotherapy of 18 head and neck cancer patients. PET imaging PVE was simulated using the discrepancy between with and without iterative deconvolution\u2010based PVE corrections. Effect of tumor DIR uncertainty was simulated using the discrepancy between two DIR algorithms, including one with and one without soft\u2010tissue mechanical correction for the voxel displacement. The effect of TI variation was simulated using linear interpolation on the dual\u2010point PET\/CT images. Tumor voxel pretreatment metabolic activity (SUV<jats:sub>0<\/jats:sub>) and dose\u2013response matrix (DRM) discrepancies induced by each of the three uncertainties were quantified, respectively. Adverse effects of tumor voxel SUV<jats:sub>0<\/jats:sub> and DRM discrepancies on tumor control probability (TCP) in DPbN were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Partial volume effect and TI variations of 10 mins induced a mean\u00a0\u00b1\u00a0standard deviation (SD) of tumor voxel SUV<jats:sub>0<\/jats:sub> discrepancies to be \u22120.7%\u00a0\u00b1\u00a09.2% and 0%\u00a0\u00b1\u00a04.8%, respectively. Tumor voxel DRM discrepancies induced by PVE, tumor DIR discrepancy, and TI variations were 0.6%\u00a0\u00b1\u00a08.9%, 1.7%\u00a0\u00b1\u00a09.1%, and 0%\u00a0\u00b1\u00a07%, respectively. Partial volume effect induced SUV<jats:sub>0<\/jats:sub> and DRM discrepancies correlated significantly with the tumor shape and FDG uptake heterogeneity. Tumor DIR uncertainty\u2010induced DRM discrepancy correlated significantly with the tumor volume and shrinkage during treatment. Among the three uncertainties, PVE dominated the adverse effects on the TCP, with a mean\u00a0\u00b1\u00a0SD of TCP reduction to be 12.7%\u00a0\u00b1\u00a09.8% for all tumors if no compensation was applied for.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Effect of uncertainties in quantitative FDG\u2010PET\/CT imaging feedback on intratumoral dose\u2013response quantification was not negligible. These uncertainties primarily caused by PVE and tumor DIR were highly dependent on individual tumor shape, volume, shrinkage during treatment, and pretreatment SUV heterogeneity, which can be managed individually. The adverse effects of these uncertainties could be minimized by using proper PVE corrections and DIR methods and compensated for in the clinical implementation of DPbN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.14482","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T20:17:08Z","timestamp":1600892228000},"page":"5681-5692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of uncertainties in quantitative <sup>18<\/sup>F\u2010FDG PET\/CT imaging feedback for intratumoral dose\u2010response assessment and dose painting by number"],"prefix":"10.1002","volume":"47","author":[{"given":"Shupeng","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology William Beaumont Hospital Royal Oak MI 48073 USA"},{"name":"Medical Physics School of Medicine Wayne State University Detroit MI 48201 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