Advancing Normal Tissue Complication Probability Modeling with Supervised Contrastive Learning for Predicting Osteoradionecrosis
Open Access
- 23 March 2026
- conference paper
- Published by Association for Computing Machinery (ACM)
- Vol. 2026, 140-147
Abstract
Normal tissue complication probability (NTCP) modeling using dose–volume histograms (DVHs) is fundamentally challenged by high dimensionality, severe multicollinearity, and substantial overlap between DVH profiles of patients with differing toxicity outcomes, limiting the effectiveness of classical classification approaches. We introduce SC–NTCP, a supervised contrastive learning framework that transforms DVH data into a compact, separable latent representation optimized for predicting osteoradionecrosis (ORN) in head and neck cancer patients. Rather than relying on raw, high-dimensional DVH features, SC–NTCP explicitly maximizes intra-class similarity and inter-class separability within the embedding space, enabling more accurate downstream classification. Using a cohort of head and neck cancer patients, we benchmarked SC–NTCP against logistic regression, support vector machines, multilayer perceptrons, and convolutional neural networks. SC–NTCP demonstrated superior discrimination (AUC = 0.77), improved calibration, and enhanced interpretability via gradient-based feature attribution, while the integration of clinical covariates further augmented predictive performance. By addressing the inherent limitations of DVH data, SC–NTCP offers a principled and interpretable approach for robust radiation toxicity prediction, with the potential to inform personalized treatment planning and improve clinical outcomes.Keywords
Funding Information
- National Institutes of Health (RO1CA258827)
- National Institutes of Health (NIH) UG3 (TR004501)
- National Science Foundation (NSF) CNS (2320261)
- National Institutes of Health (NA)
This publication has 21 references indexed in Scilit:
- Externally validated digital decision support tool for time-to-osteoradionecrosis risk-stratification using right-censored multi-institutional observational cohortsRadiotherapy and Oncology, 2025
- Cluster-Based Toxicity Estimation of Osteoradionecrosis Via Unsupervised Machine Learning: Moving Beyond Single Dose-Parameter Normal Tissue Complication Probability by Using Whole Dose-Volume Histograms for Cohort Risk StratificationInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2024
- SCEHR: Supervised Contrastive Learning for Clinical Risk Prediction using Electronic Health RecordsIEEE International Conference on Data Mining (ICDM), 2021
- Normal Tissue Complication Probability (NTCP) Prediction Model for Osteoradionecrosis of the Mandible in Patients With Head and Neck Cancer After Radiation Therapy: Large-Scale Observational CohortInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2021
- Osteoradionecrosis: Exposing the Evidence Not the BoneInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2021
- Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise reviewInternational Dental Journal, 2020
- Osteoradionecrosis of the mandible after radiotherapy for head and neck cancer: risk factors and dose-volume correlationsActa Oncologica, 2019
- Incidence of, and risk factors for, mandibular osteoradionecrosis in patients with oral cavity and oropharynx cancersOral Oncology, 2017
- Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal CancerInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2013
- Use of Normal Tissue Complication Probability Models in the ClinicInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2010