Functional dose-volume histograms are proposed as an extension of the conventional dose-volume histograms, for quantitative assessment of three-dimensional radiation dose coverage of functionally heterogeneous normal organs. Examples are given to illustrate possible applications of this approach to the treatment of a brain tumour or a lung tumour, in which cases the distribution of the normal organ function can be obtained from functional dose-volume modalities. It is shown that a significant difference exists between the functional dose-volume histograms and the conventional dose-volume histograms when the normal organ function is non-uniformly distributed within the organ. Utilization of functional dose-volume histograms as the input for the calculation of normal tissue complication probabilities is discussed for different normal tissue structures.
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