### Abstract

The therapy operating characteristic (TOC) curve, developed in the context of radiation therapy, is a plot of the probability of tumor control versus the probability of normal-tissue complications as the overall radiation dose level is varied, e.g., by varying the beam current in external-beam radiotherapy or the total injected activity in radionuclide therapy. This paper shows how TOC can be applied to chemotherapy with the administered drug dosage as the variable. The area under a TOC curve (AUTOC) can be used as a figure of merit for therapeutic efficacy, analogous to the area under an ROC curve (AUROC), which is a figure of merit for diagnostic efficacy. In radiation therapy, AUTOC can be computed for a single patient by using image data along with radiobiological models for tumor response and adverse side effects. The mathematical analogy between response of observers to images and the response of tumors to distributions of a chemotherapy drug is exploited to obtain linear discriminant functions from which AUTOC can be calculated. Methods for using mathematical models of drug delivery and tumor response with imaging data to estimate patient-specific parameters that are needed for calculation of AUTOC are outlined. The implications of this viewpoint for clinical trials are discussed.

Original language | English (US) |
---|---|

Article number | 023502 |

Journal | Journal of Medical Imaging |

Volume | 3 |

Issue number | 2 |

DOIs | |

State | Published - Apr 1 2016 |

### Fingerprint

### Keywords

- chemotherapy
- normal tissue complications
- positron emission tomography
- radiation therapy
- single-photon emission computed tomography
- Therapy operating characteristic
- tumor control

### ASJC Scopus subject areas

- Bioengineering
- Radiology Nuclear Medicine and imaging

### Cite this

*Journal of Medical Imaging*,

*3*(2), [023502]. https://doi.org/10.1117/1.JMI.3.2.023502

**Therapy operating characteristic curves : Tools for precision chemotherapy.** / Barrett, Harrison H; Alberts, David S; Woolfenden, James M.; Caucci, Luca; Hoppin, John W.

Research output: Contribution to journal › Article

*Journal of Medical Imaging*, vol. 3, no. 2, 023502. https://doi.org/10.1117/1.JMI.3.2.023502

}

TY - JOUR

T1 - Therapy operating characteristic curves

T2 - Tools for precision chemotherapy

AU - Barrett, Harrison H

AU - Alberts, David S

AU - Woolfenden, James M.

AU - Caucci, Luca

AU - Hoppin, John W.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - The therapy operating characteristic (TOC) curve, developed in the context of radiation therapy, is a plot of the probability of tumor control versus the probability of normal-tissue complications as the overall radiation dose level is varied, e.g., by varying the beam current in external-beam radiotherapy or the total injected activity in radionuclide therapy. This paper shows how TOC can be applied to chemotherapy with the administered drug dosage as the variable. The area under a TOC curve (AUTOC) can be used as a figure of merit for therapeutic efficacy, analogous to the area under an ROC curve (AUROC), which is a figure of merit for diagnostic efficacy. In radiation therapy, AUTOC can be computed for a single patient by using image data along with radiobiological models for tumor response and adverse side effects. The mathematical analogy between response of observers to images and the response of tumors to distributions of a chemotherapy drug is exploited to obtain linear discriminant functions from which AUTOC can be calculated. Methods for using mathematical models of drug delivery and tumor response with imaging data to estimate patient-specific parameters that are needed for calculation of AUTOC are outlined. The implications of this viewpoint for clinical trials are discussed.

AB - The therapy operating characteristic (TOC) curve, developed in the context of radiation therapy, is a plot of the probability of tumor control versus the probability of normal-tissue complications as the overall radiation dose level is varied, e.g., by varying the beam current in external-beam radiotherapy or the total injected activity in radionuclide therapy. This paper shows how TOC can be applied to chemotherapy with the administered drug dosage as the variable. The area under a TOC curve (AUTOC) can be used as a figure of merit for therapeutic efficacy, analogous to the area under an ROC curve (AUROC), which is a figure of merit for diagnostic efficacy. In radiation therapy, AUTOC can be computed for a single patient by using image data along with radiobiological models for tumor response and adverse side effects. The mathematical analogy between response of observers to images and the response of tumors to distributions of a chemotherapy drug is exploited to obtain linear discriminant functions from which AUTOC can be calculated. Methods for using mathematical models of drug delivery and tumor response with imaging data to estimate patient-specific parameters that are needed for calculation of AUTOC are outlined. The implications of this viewpoint for clinical trials are discussed.

KW - chemotherapy

KW - normal tissue complications

KW - positron emission tomography

KW - radiation therapy

KW - single-photon emission computed tomography

KW - Therapy operating characteristic

KW - tumor control

UR - http://www.scopus.com/inward/record.url?scp=85001515816&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85001515816&partnerID=8YFLogxK

U2 - 10.1117/1.JMI.3.2.023502

DO - 10.1117/1.JMI.3.2.023502

M3 - Article

AN - SCOPUS:85001515816

VL - 3

JO - Journal of Medical Imaging

JF - Journal of Medical Imaging

SN - 0720-048X

IS - 2

M1 - 023502

ER -