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Eckrich C, Lee B, Wang C, Light K, Chino J, Rodrigues A, Craciunescu O. Evaluation of cumulative dose distributions from external beam radiation therapy using CT-to-CBCT deformable image registration (DIR) for cervical cancer patients. J Appl Clin Med Phys 2024:e14538. [PMID: 39365744 DOI: 10.1002/acm2.14538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/08/2024] [Accepted: 08/22/2024] [Indexed: 10/06/2024] Open
Abstract
PURPOSE To investigate dose differences between the planning CT (pCT) and dose calculated on pre-treatment verification CBCTs using DIR and dose summation for cervical cancer patients. METHODS Cervical cancer patients treated at our institution with 45 Gy EBRT undergo a pCT and 5 CBCTs, once every five fractions of treatment. A free-form intensity-based DIR in MIM was performed between the pCT and each CBCT using the "Merged CBCT" feature to generate an extended FOV-CBCT (mCBCT). DIR-generated bladder and rectum contours were adjusted by a physician, and dice similarity coefficients (DSC) were calculated. After deformation, the investigated doses were (1) recalculated in Eclipse using original plan parameters (ecD), and (2) deformed from planning dose (pD) using the deformation matrix in MIM (mdD). Dose summation was performed to the first week's mCBCT. Dose distributions were compared for the bladder, rectum, and PTV in terms of percent dose difference, dose volume histograms (DVHs), and gamma analysis between the calculated doses. RESULTS For the 20 patients, the mean DSC was 0.68 ± 0.17 for bladder and 0.79 ± 0.09 for rectum. Most patients were within 5% of pD for D2cc (19/20), Dmax (17/20), and Dmean (16/20). All patients demonstrated a percent difference > 5% for bladder V45 due to variations in bladder volume from the pCT. D90 showed fewer differences with 19/20 patients within 2% of pD. Gamma rates between pD and ecD averaged 94% for bladder and 94% for rectum, while pD and mdD exhibited slightly better performance for bladder (93%) and lower for rectum (85%). CONCLUSION Using DIR with weekly CBCT images, the MIM deformed dose (mdD) was found to be in close agreement with the Eclipse calculated dose (ecD). The proposed workflow should be used on a case-by-case basis when the weekly CBCT shows marked difference in organs-at-risk from the planning CT.
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Affiliation(s)
- Carolyn Eckrich
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
| | | | - Chunhao Wang
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
| | - Kim Light
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
| | - Junzo Chino
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
| | - Anna Rodrigues
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
| | - Oana Craciunescu
- Duke University Medical Center, Department of Radiation Oncology, Durham, North Carolina, USA
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Liu Y, Zhang P, Hong J, Alam S, Kuo L, Hu YC, Lu W, Cerviño L. Geometric evaluation and quantifying dosimetric impact of diverse deformable image registration algorithms on abdomen images with biomechanically modeled deformations. J Appl Clin Med Phys 2024:e14511. [PMID: 39258711 DOI: 10.1002/acm2.14511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 06/24/2024] [Accepted: 08/13/2024] [Indexed: 09/12/2024] Open
Abstract
PURPOSE Deformable image registration (DIR) has been increasingly used in radiation therapy (RT). The accuracy of DIR algorithms and how it impacts on the RT plan dosimetrically were examined in our study for abdominal sites using biomechanically modeled deformations. METHODS Five pancreatic cancer patients were enrolled in this study. Following the guidelines of AAPM TG-132, a patient-specific quality assurance (QA) workflow was developed to evaluate DIR for the abdomen using the TG-132 recommended virtual simulation software ImSimQA (Shrewsbury, UK). First, the planning CT was deformed to simulate respiratory motion using the embedded biomechanical model in ImSimQA. Additionally, 5 mm translational motion was added to the stomach, duodenum, and small bowel. The original planning CT and the deformed CT were then imported into Eclipse and MIM to perform DIR. The output displacement vector fields (DVFs) were compared with the ground truth from ImSimQA. Furthermore, the original treatment plan was recalculated on the ground-truth deformed CT and the deformed CT (with Eclipse and MIM DVF). The dose errors were calculated on a voxel-to-voxel basis. RESULTS Data analysis comparing DVF from Eclipse versus MIM show the average mean DVF magnitude errors of 2.8 ± 1.0 versus 1.1 ± 0.7 mm for stomach and duodenum, 5.2 ± 4.0 versus 2.5 ± 1.0 mm for small bowel, and 4.8 ± 4.1 versus 2.7 ± 1.1 mm for the gross tumor volume (GTV), respectively, across all patients. The mean dose error on stomach+duodenum and small bowel were 2.3 ± 0.6% for Eclipse, and 1.0 ± 0.3% for MIM. As the DIR magnitude error increases, the dose error range increase, for both Eclipse and MIM. CONCLUSION In our study, an initial assessment was conducted to evaluate the accuracy of DIR and its dosimetric impact on radiotherapy. A patient-specific DIR QA workflow was developed for pancreatic cancer patients. This workflow exhibits promising potential for future implementation as a clinical workflow.
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Affiliation(s)
- Yilin Liu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Pengpeng Zhang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jun Hong
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sadegh Alam
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - LiCheng Kuo
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yu-Chi Hu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Wei Lu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Laura Cerviño
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Kumar MA, Hajare R, Nath BD, Lakshmi KKS, Mahantshetty UM. Performance Evaluation of Deformable Image Registration Systems - SmartAdapt ® and Velocity™. J Med Phys 2024; 49:240-249. [PMID: 39131429 PMCID: PMC11309134 DOI: 10.4103/jmp.jmp_167_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/27/2024] [Accepted: 03/20/2024] [Indexed: 08/13/2024] Open
Abstract
Aim To commission and validate commercial deformable image registration (DIR) systems (SmartAdapt® and Velocity™) using task group 132 (TG-132) digital phantom datasets. Additionally, the study compares and verifies the DIR algorithms of the two systems. Materials and Methods TG-132 digital phantoms were obtained from the American Association of Physicists in Medicine website and imported into SmartAdapt® and Velocity™ systems for commissioning and validation. The registration results were compared with known shifts using rigid registrations and deformable registrations. Virtual head and neck phantoms obtained online (DIR Evaluation Project) and some selected clinical data sets from the department were imported into the two DIR systems. For both of these datasets, DIR was carried out between the source and target images, and the contours were then propagated from the source to the target image data set. The dice similarity coefficient (DSC), mean distance to agreement (MDA), and Jacobian determinant measures were utilised to evaluate the registration results. Results The recommended criteria for commissioning and validation of DIR system from TG-132 was error <0.5*voxel dimension (vd). Translation only registration: Both systems met TG-132 recommendations except computed tomography (CT)-positron emission tomography registration in both systems (Velocity ~1.1*vd, SmartAdapt ~1.6*vd). Translational and rotational registration: Both systems failed the criteria for all modalities (For velocity, error ranged from 0.6*vd [CT-CT registration] to 3.4*vd [CT-cone-beam CT (CBCT) registration]. For SmartAdapt® the range was 0.6*vd [CT-CBCT] to 3.6*vd [CT-CT]). Mean ± standard deviation for DSC, MDA and Jacobian metrics were used to compare the DIR results between SmartAdapt® and Velocity™. Conclusion The DIR algorithms of SmartAdapt® and Velocity™ were commissioned and their deformation results were compared. Both systems can be used for clinical purpose. While there were only minimal differences between the two systems, Velocity™ provided lower values for parotids, bladder, rectum, and prostate (soft tissue) compared to SmartAdapt. However, for mandible, spinal cord, and femoral heads (rigid structures), both systems showed nearly identical results.
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Affiliation(s)
- M. Anil Kumar
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Raghavendra Hajare
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Bhakti Dev Nath
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India
| | - K. K. Sree Lakshmi
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
| | - Umesh M. Mahantshetty
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
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Song H, Yang S, Wu Z, Moradi H, Taylor RH, Kang JU, Salcudean SE, Boctor EM. Arc-to-line frame registration method for ultrasound and photoacoustic image-guided intraoperative robot-assisted laparoscopic prostatectomy. Int J Comput Assist Radiol Surg 2024; 19:199-208. [PMID: 37610603 DOI: 10.1007/s11548-023-02984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/05/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To achieve effective robot-assisted laparoscopic prostatectomy, the integration of transrectal ultrasound (TRUS) imaging system which is the most widely used imaging modality in prostate imaging is essential. However, manual manipulation of the ultrasound transducer during the procedure will significantly interfere with the surgery. Therefore, we propose an image co-registration algorithm based on a photoacoustic marker (PM) method, where the ultrasound/photoacoustic (US/PA) images can be registered to the endoscopic camera images to ultimately enable the TRUS transducer to automatically track the surgical instrument. METHODS An optimization-based algorithm is proposed to co-register the images from the two different imaging modalities. The principle of light propagation and an uncertainty in PM detection were assumed in this algorithm to improve the stability and accuracy of the algorithm. The algorithm is validated using the previously developed US/PA image-guided system with a da Vinci surgical robot. RESULTS The target-registration-error (TRE) is measured to evaluate the proposed algorithm. In both simulation and experimental demonstration, the proposed algorithm achieved a sub-centimeter accuracy which is acceptable in practical clinics (i.e., 1.15 ± 0.29 mm from the experimental evaluation). The result is also comparable with our previous approach (i.e., 1.05 ± 0.37 mm), and the proposed method can be implemented with a normal white light stereo camera and does not require highly accurate localization of the PM. CONCLUSION The proposed frame registration algorithm enabled a simple yet efficient integration of commercial US/PA imaging system into laparoscopic surgical setting by leveraging the characteristic properties of acoustic wave propagation and laser excitation, contributing to automated US/PA image-guided surgical intervention applications.
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Affiliation(s)
- Hyunwoo Song
- Department of Computer Science, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Shuojue Yang
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Zijian Wu
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Hamid Moradi
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Russell H Taylor
- Department of Computer Science, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Jin U Kang
- Department of Electrical and Computer Engineering, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Septimiu E Salcudean
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Emad M Boctor
- Department of Computer Science, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA.
- Laboratory for Computational Sensing and Robotics, The Johns Hopkins University, Baltimore, MD, 21218, USA.
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Nenoff L, Amstutz F, Murr M, Archibald-Heeren B, Fusella M, Hussein M, Lechner W, Zhang Y, Sharp G, Vasquez Osorio E. Review and recommendations on deformable image registration uncertainties for radiotherapy applications. Phys Med Biol 2023; 68:24TR01. [PMID: 37972540 PMCID: PMC10725576 DOI: 10.1088/1361-6560/ad0d8a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023]
Abstract
Deformable image registration (DIR) is a versatile tool used in many applications in radiotherapy (RT). DIR algorithms have been implemented in many commercial treatment planning systems providing accessible and easy-to-use solutions. However, the geometric uncertainty of DIR can be large and difficult to quantify, resulting in barriers to clinical practice. Currently, there is no agreement in the RT community on how to quantify these uncertainties and determine thresholds that distinguish a good DIR result from a poor one. This review summarises the current literature on sources of DIR uncertainties and their impact on RT applications. Recommendations are provided on how to handle these uncertainties for patient-specific use, commissioning, and research. Recommendations are also provided for developers and vendors to help users to understand DIR uncertainties and make the application of DIR in RT safer and more reliable.
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Affiliation(s)
- Lena Nenoff
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, Dresden Germany
- Helmholtz-Zentrum Dresden—Rossendorf, Institute of Radiooncology—OncoRay, Dresden, Germany
| | - Florian Amstutz
- Department of Physics, ETH Zurich, Switzerland
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Martina Murr
- Section for Biomedical Physics, Department of Radiation Oncology, University of Tübingen, Germany
| | | | - Marco Fusella
- Department of Radiation Oncology, Abano Terme Hospital, Italy
| | - Mohammad Hussein
- Metrology for Medical Physics, National Physical Laboratory, Teddington, United Kingdom
| | - Wolfgang Lechner
- Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Ye Zhang
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - Greg Sharp
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Eliana Vasquez Osorio
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
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6
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Zhao T, Chen Y, Qiu B, Zhang J, Liu H, Zhang X, Zhang R, Jiang P, Wang J. Evaluating the accumulated dose distribution of organs at risk in combined radiotherapy for cervical carcinoma based on deformable image registration. Brachytherapy 2023; 22:174-180. [PMID: 36336564 DOI: 10.1016/j.brachy.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/06/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the feasibility and value of deformable image registration (DIR) in calculating the cumulative doses of organs at risk (OARs) in the combined radiotherapy of cervical cancer. PATIENTS AND METHODS Thirty cervical cancer patients treated with external beam radiotherapy (EBRT) combined with intracavitary brachytherapy (ICBT) were reviewed. The simulation CT images of EBRT and ICBT were imported into Varian Velocity 4.1 for the DIR-based dose accumulation. Cumulative dose-volume parameters of D2cc for rectum and bladder were compared between the direct addition (DA) and DIR methods. The quantitative parameters were measured to evaluate the accuracy of DIR. RESULTS The three-dimensional cumulative dose distribution of the tumor and OARs were graphically well illustrated by composite isodose lines. In combined EBRT and ICBT, the mean cumulative bladder D2cc calculated by DIR and DA was 86.13 Gy and 86.27 Gy, respectively. The mean cumulative rectal D2cc calculated by DIR and DA was 72.97 Gy and 73.90 Gy, respectively. No significant differences were noted between these two methods (p > 0.05). As to the parameters used to evaluate the DIR accuracy, the mean DSC, Jacobian, MDA (mm) and Hausdorff distance (mm) were 0.79, 1.0, 3.84, and 22.01 respectively for the bladder and 0.53, 1.2, 7.31, and 29.58 respectively for the rectum. In this study, the DSC seemed to be slightly lower compared with previous studies. CONCLUSION Dose accumulation based on DIR might be an alternative method to illustrate and evaluate the cumulative doses of the OARs in combined radiotherapy for cervical cancer. However, DIR should be used with caution before overcoming the relevant limitations.
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Affiliation(s)
- Tiandi Zhao
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Jiashuang Zhang
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Hao Liu
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Xile Zhang
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Ruilin Zhang
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital (100191), Beijing, China.
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Lallement A, Noblet V, Antoni D, Meyer P. Detecting and quantifying spatial misalignment between longitudinal kilovoltage computed tomography (kVCT) scans of the head and neck by using convolutional neural networks (CNNs). Technol Health Care 2023:THC220519. [PMID: 36776082 DOI: 10.3233/thc-220519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND Adaptive radiotherapy (ART) aims to address anatomical modifications appearing during the treatment of patients by modifying the planning treatment according to the daily positioning image. Clinical implementation of ART relies on the quality of the deformable image registration (DIR) algorithms included in the ART workflow. To translate ART into clinical practice, automatic DIR assessment is needed. OBJECTIVE This article aims to estimate spatial misalignment between two head and neck kilovoltage computed tomography (kVCT) images by using two convolutional neural networks (CNNs). METHODS The first CNN quantifies misalignments between 0 mm and 15 mm and the second CNN detects and classifies misalignments into two classes (poor alignment and good alignment). Both networks take pairs of patches of 33x33x33 mm3 as inputs and use only the image intensity information. The training dataset was built by deforming kVCT images with basis splines (B-splines) to simulate DIR error maps. The test dataset was built using 2500 landmarks, consisting of hard and soft landmark tissues annotated by 6 clinicians at 10 locations. RESULTS The quantification CNN reaches a mean error of 1.26 mm (± 1.75 mm) on the landmark set which, depending on the location, has annotation errors between 1 mm and 2 mm. The errors obtained for the quantification network fit the computed interoperator error. The classification network achieves an overall accuracy of 79.32%, and although the classification network overdetects poor alignments, it performs well (i.e., it achieves a rate of 90.4%) in detecting poor alignments when given one. CONCLUSION The performances of the networks indicate the feasibility of using CNNs for an agnostic and generic approach to misalignment quantification and detection.
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Affiliation(s)
| | | | - Delphine Antoni
- Department of Radiation Therapy, Institut de Cancérologie de Strasbourg, Strasbourg, France
| | - Philippe Meyer
- ICube-UMR 7357, Strasbourg, France.,Department of Medical Physics, Institut de Cancérologie de Strasbourg, Strasbourg, France
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Van Elburg D, Roumeliotis M, Fenster A, Phan T, Meyer T. Technical Note: Commissioning of an ultrasound-compatible surrogate vaginal cylinder for transvaginal ultrasound-based gynecologic high-dose-rate brachytherapy. Med Phys 2022; 49:2203-2211. [PMID: 35199856 DOI: 10.1002/mp.15559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/19/2022] [Accepted: 02/12/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To provide a comprehensive set of commissioning tests for clinical implementation of three-dimensional transvaginal ultrasound (3D TVUS) as a replacement of computed tomography (CT) for applicator reconstruction in gynecologic intracavitary high-dose-rate brachytherapy with a multi-channel vaginal cylinder. METHODS We introduce an ultrasound-compatible "surrogate" vaginal cylinder (SVC) for reconstruction of Elekta's CT-MR Multi Channel Applicator (MCVC) in 3D TVUS. The MCVC is digitized over the SVC in 3DUS using digital library model overlay. Consulting guidelines from various sources (CPQR, GEC-ESTRO, AAPM), we identify and describe three tests specific to commissioning the SVC: 1) verification of SVC outer dimensions, 2) source position accuracy of MCVC digitization over the SVC in 3D TVUS, and 3) MRI/US registration error. RESULTS The SVC outer dimensions (diameter and A-D marker locations) were well matched to the MCVC, however a 0.6 mm discrepancy in length between cylinder tips was observed. Source position accuracy was within 1 mm (tolerance recommended by CPQR) when reconstructing the MCVC in 3D TVUS. Dice similarity coefficients and target registration error for MRI/3D TVUS registration was similar to MRI/CT registration, which is the clinical standard. CONCLUSIONS These commissioning tests are performed using institutional equipment but provide the framework for any practitioners to repeat in their own setup, to demonstrate safe adoption of the 3D TVUS system for patient treatments. We demonstrate that MRI/US-based workflow achieves similar source position accuracy and image registration error as standard MRI/CT, which is consistent with standard tolerances. This is a critical step towards replacement of CT with US in gynecologic high-dose-rate brachytherapy treatments with the MCVC. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Devin Van Elburg
- Department of Physics & Astronomy, University of Calgary, Calgary, AB, T2N 1N4, Canada.,Medical Physics Department, Tom Baker Cancer Centre, Calgary, AB, T2N 4N2, Canada
| | - Michael Roumeliotis
- Department of Physics & Astronomy, University of Calgary, Calgary, AB, T2N 1N4, Canada.,Medical Physics Department, Tom Baker Cancer Centre, Calgary, AB, T2N 4N2, Canada.,Department of Oncology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Aaron Fenster
- School of Biomedical Engineering, University of Western Ontario, London ON, N6A 3K7, Canada.,Robarts Research Institute, University of Western Ontario, London ON, N6A 5B7, Canada
| | - Tien Phan
- Department of Oncology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Tyler Meyer
- Department of Physics & Astronomy, University of Calgary, Calgary, AB, T2N 1N4, Canada.,Medical Physics Department, Tom Baker Cancer Centre, Calgary, AB, T2N 4N2, Canada.,Department of Oncology, University of Calgary, Calgary, AB, T2N 1N4, Canada
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9
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Rong Y, Rosu-Bubulac M, Benedict SH, Cui Y, Ruo R, Connell T, Kashani R, Latifi K, Chen Q, Geng H, Sohn J, Xiao Y. Rigid and Deformable Image Registration for Radiation Therapy: A Self-Study Evaluation Guide for NRG Oncology Clinical Trial Participation. Pract Radiat Oncol 2021; 11:282-298. [PMID: 33662576 PMCID: PMC8406084 DOI: 10.1016/j.prro.2021.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/05/2021] [Accepted: 02/16/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE The registration of multiple imaging studies to radiation therapy computed tomography simulation, including magnetic resonance imaging, positron emission tomography-computed tomography, etc. is a widely used strategy in radiation oncology treatment planning, and these registrations have valuable roles in image guidance, dose composition/accumulation, and treatment delivery adaptation. The NRG Oncology Medical Physics subcommittee formed a working group to investigate feasible workflows for a self-study credentialing process of image registration commissioning. METHODS AND MATERIALS The American Association of Physicists in Medicine (AAPM) Task Group 132 (TG132) report on the use of image registration and fusion algorithms in radiation therapy provides basic guidelines for quality assurance and quality control of the image registration algorithms and the overall clinical process. The report recommends a series of tests and the corresponding metrics that should be evaluated and reported during commissioning and routine quality assurance, as well as a set of recommendations for vendors. The NRG Oncology medical physics subcommittee working group found incompatibility of some digital phantoms with commercial systems. Thus, there is still a need to provide further recommendations in terms of compatible digital phantoms, clinical feasible workflow, and achievable thresholds, especially for future clinical trials involving deformable image registration algorithms. Nine institutions participated and evaluated 4 commonly used commercial imaging registration software and various versions in the field of radiation oncology. RESULTS AND CONCLUSIONS The NRG Oncology Working Group on image registration commissioning herein provides recommendations on the use of digital phantom/data sets and analytical software access for institutions and clinics to perform their own self-study evaluation of commercial imaging systems that might be employed for coregistration in radiation therapy treatment planning and image guidance procedures. Evaluation metrics and their corresponding values were given as guidelines to establish practical tolerances. Vendor compliance for image registration commissioning was evaluated, and recommendations were given for future development.
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Affiliation(s)
- Yi Rong
- Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, California; Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona.
| | - Mihaela Rosu-Bubulac
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia
| | - Stanley H Benedict
- Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, California
| | - Yunfeng Cui
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Russell Ruo
- Department of Medical Physics, McGill University Health Center, Montreal, QC, Canada
| | - Tanner Connell
- Department of Medical Physics, McGill University Health Center, Montreal, QC, Canada
| | - Rojano Kashani
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Kujtim Latifi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Quan Chen
- Department of Radiation Medicine, University of Kentucky, Lexington, Kentucky
| | - Huaizhi Geng
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason Sohn
- Department of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Ying Xiao
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
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10
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Sasaki M. [10. Automatic Contour Segmentation Technology in the Radiotherapy]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:591-595. [PMID: 34148901 DOI: 10.6009/jjrt.2021_jsrt_77.6.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Motoharu Sasaki
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School
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Mee M, Stewart K, Lathouras M, Truong H, Hargrave C. Evaluation of a deformable image registration quality assurance tool for head and neck cancer patients. J Med Radiat Sci 2020; 67:284-293. [PMID: 33615738 PMCID: PMC7754017 DOI: 10.1002/jmrs.428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A challenge in implementing deformable image registration (DIR) in radiation therapy planning is effectively communicating registration accuracy to the radiation oncologist. This study aimed to evaluate the MIM® quality assurance (QA) tool for rating DIR accuracy. METHODS Retrospective DIR was performed on CT images for 35 head and neck cancer patients. The QA tool was used to rate DIR accuracy as good, fair or bad. Thirty registered patient images were assessed independently by three RTs and a further five patients assessed by five RTs. Ratings were evaluated by comparison of Hausdorff Distance (HD), Mean Distance to Agreement (MDA), Dice Similarity Coefficients (DSC) and Jacobian determinants for parotid and mandible subregions on the two CTs post-DIR. Inter-operator reliability was assessed using Krippendorff's alpha coefficient (KALPA). Rating time and volume measures for each rating were also calculated. RESULTS Quantitative metrics calculated for most anatomical subregions reflected the expected trend by registration accuracy, with good obtaining the most ideal values on average (HD = 7.50 ± 3.18, MDA = 0.64 ± 0.47, DSC = 0.90 ± 0.07, Jacobian = 0.95 ± 0.06). Highest inter-operator reliability was observed for good ratings and within the parotids (KALPA 0.66-0.93), whilst ratings varied the most in regions of dental artefact. Overall, average rating time was 33 minutes and the least commonly applied rating by volume was fair. CONCLUSION Results from qualitative and quantitative data, operator rating differences and rating time suggest highlighting only bad regions of DIR accuracy and implementing clinical guidelines and RT training for consistent and efficient use of the QA tool.
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Affiliation(s)
- Molly Mee
- Faculty of HealthSchool of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Kate Stewart
- Faculty of HealthSchool of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Radiation OncologyRoyal Brisbane and Women's Hospital, Metro North Health Service DistrictHerstonQueenslandAustralia
| | - Marika Lathouras
- Department of Radiation OncologyRoyal Brisbane and Women's Hospital, Metro North Health Service DistrictHerstonQueenslandAustralia
| | - Helen Truong
- Department of Radiation OncologyRoyal Brisbane and Women's Hospital, Metro North Health Service DistrictHerstonQueenslandAustralia
| | - Catriona Hargrave
- Faculty of HealthSchool of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
- Radiation Oncology PAH – Raymond Terrace CampusDivision of Cancer ServicesMetro South Health Service DistrictSouth BrisbaneQueenslandAustralia
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Bjarnason TA, Rees R, Kainz J, Le LH, Stewart EE, Preston B, Elbakri I, Fife IAJ, Lee T, Gagnon IMB, Arsenault C, Therrien P, Kendall E, Tonkopi E, Cottreau M, Aldrich JE. An international survey on the clinical use of rigid and deformable image registration in radiotherapy. J Appl Clin Med Phys 2020; 21:10-24. [PMID: 32915492 PMCID: PMC7075391 DOI: 10.1002/acm2.12957] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Rigid image registration (RIR) and deformable image registration (DIR) are widely used in radiotherapy. This project aims to capture current international approaches to image registration. METHODS A survey was designed to identify variations in use, resources, implementation, and decision-making criteria for clinical image registration. This was distributed to radiotherapy centers internationally in 2018. RESULTS There were 57 responses internationally, from the Americas (46%), Australia/New Zealand (32%), Europe (12%), and Asia (10%). Rigid image registration and DIR were used clinically for computed tomography (CT)-CT registration (96% and 51%, respectively), followed by CT-PET (81% and 47%), CT-CBCT (84% and 19%), CT-MR (93% and 19%), MR-MR (49% and 5%), and CT-US (9% and 0%). Respondent centers performed DIR using dedicated software (75%) and treatment planning systems (29%), with 84% having some form of DIR software. Centers have clinically implemented DIR for atlas-based segmentation (47%), multi-modality treatment planning (65%), and dose deformation (63%). The clinical use of DIR for multi-modality treatment planning and accounting for retreatments was considered to have the highest benefit-to-risk ratio (69% and 67%, respectively). CONCLUSIONS This survey data provides useful insights on where, when, and how image registration has been implemented in radiotherapy centers around the world. DIR is mainly in clinical use for CT-CT (51%) and CT-PET (47%) for the head and neck (43-57% over all use cases) region. The highest benefit-risk ratio for clinical use of DIR was for multi-modality treatment planning and accounting for retreatments, which also had higher clinical use than for adaptive radiotherapy and atlas-based segmentation.
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Affiliation(s)
- Thorarin A. Bjarnason
- Medical ImagingInterior Health AuthorityKelownaBCCanada
- RadiologyUniversity of British ColumbiaVancouverBCCanada
- PhysicsUniversity of British Columbia OkanaganKelownaBCCanada
| | - Robert Rees
- Occupational Health & SafetyYukon Workers' Compensation Health and Safety BoardWhitehorseYKCanada
| | - Judy Kainz
- Workers' Safety and Compensation Commission for Northwest Territories and NunavutYellowknifeNTCanada
| | - Lawrence H. Le
- Diagnostic ImagingAlberta Health ServicesCalgaryABCanada
- Radiology and Diagnostic ImagingUniversity of AlbertaEdmontonABCanada
| | | | - Brent Preston
- Radiation Safety UnitGovernment of SaskatchewanSaskatoonSKCanada
| | - Idris Elbakri
- Cancer Care ManitobaWinnipegMBCanada
- Physics and AstronomyUniversity of ManitobaWinnipegMBCanada
- RadiologyUniversity of ManitobaWinnipegMBCanada
| | - Ingvar A. J. Fife
- Cancer Care ManitobaWinnipegMBCanada
- Physics and AstronomyUniversity of ManitobaWinnipegMBCanada
- RadiologyUniversity of ManitobaWinnipegMBCanada
| | - Ting‐Yim Lee
- St Joseph’s Health Care LondonLondonONCanada
- Lawson Research InstituteLondonONCanada
- Medical ImagingMedical Biophysics, OncologyRobarts Research InstituteUniversity of Western OntarioLondonONCanada
| | | | - Clément Arsenault
- Hôpital Dr Georges–L. DumontCentre d'Oncologie Dr Léon–RichardMonctonNBCanada
| | | | | | - Elena Tonkopi
- Nova Scotia Health AuthorityHalifaxNSCanada
- Diagnostic RadiologyDalhousie UniversityHalifaxNSCanada
- Radiation OncologyDalhousie UniversityHalifaxNSCanada
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Weppler S, Schinkel C, Kirkby C, Smith W. Lasso logistic regression to derive workflow-specific algorithm performance requirements as demonstrated for head and neck cancer deformable image registration in adaptive radiation therapy. Phys Med Biol 2020; 65:195013. [PMID: 32580170 DOI: 10.1088/1361-6560/ab9fc8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
As automation in radiation oncology becomes more common, it is important to determine which algorithms are equivalent for a given workflow. Often, algorithm comparisons are performed in isolation; however, clinical context can provide valuable insight into the importance of algorithm features and error magnification in subsequent workflow steps. We propose a strategy for deriving workflow-specific algorithm performance requirements. We considered two independent workflows indicating the need for radiotherapy treatment replanning for 15 head and neck cancer patients (15 planning CTs, 105 on-unit CBCTs). Each workflow was based on a different deformable image registration (DIR) algorithm. Differences in DIR output were assessed using three sets of QA metrics: (1) conventional, (2) workflow-specific, (3) a combination of (1) and (2). For a given set of algorithm metrics, lasso logistic regression modeled the probability of discrepant replan indications. Varying the minimum probability needed to predict a workflow discrepancy produced receiver operating characteristic (ROC) curves. ROC curves were compared using sensitivity, specificity, and the area under the curve (AUC). A heuristic then derived simple algorithm performance requirements. Including workflow-specific QA metrics improved AUC from 0.70 to 0.85, compared to the use of conventional metrics alone. Algorithm performance requirements had high sensitivity of 0.80, beneficial for replan assessments, with specificity of 0.57. This was an improvement over a naïve application of conventional QA criteria, which had sensitivity of 0.57 and specificity of 0.68. In addition, the algorithm performance requirements indicated practical refinements of conventional QA tolerances, indicated where auxiliary workflow processes should be standardized, and may be used to prioritize structures for manual review. Our algorithm performance requirements outperformed current comparison recommendations and provided practical means for ensuring workflow equivalence. This strategy may aid in trial credentialing, algorithm development, and streamlining expert adjustment of workflow output.
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Affiliation(s)
- Sarah Weppler
- Department of Physics and Astronomy, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N 1N4, Canada. Department of Medical Physics, Tom Baker Cancer Centre, 1331 29 St NW, Calgary, Alberta, T2N 4N2, Canada. Author to whom any correspondence should be addressed
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Free-to-use DIR solutions in radiotherapy: Benchmark against commercial platforms through a contour-propagation study. Phys Med 2020; 74:110-117. [PMID: 32464468 DOI: 10.1016/j.ejmp.2020.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/08/2020] [Accepted: 05/17/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE A contour propagation study has been conducted to benchmark three algorithms for Deformable Image Registration (DIR) freely available online against well-established commercial solutions. METHODS ElastiX, BRAINS and Plastimach, available as modules in the open source platform 3DSlicer, were tested as the recent AAPM Task group 132 guidelines proposes. The overlap of the DIR-mapped ROIs in four computational anthropomorphic phantoms was measured. To avoid bias every algorithm was left to run without any human interaction nor particular registration strategy. The accuracy of the algorithms was measured using the Dice Similarity Coefficient (DSC) and Mean Distance to Conformity (MDC) metrics. The registration quality was compared to the recommended geometrical accuracy suggested by AAPM TG132 and to the results of a large population-based study performed with commercial DIR solutions. RESULTS The considered free-to-use DIR solutions generally meet acceptable accuracy and good overlap (DSC > 0.85). Mild failures (DSC < 0.75) were detected only for the smallest structures. In case of extremely severe deformations acceptable accuracy was not met (MDC > 3 mm). The morphing capability of the tested algorithms equals those of commercial systems when the user interaction is avoided. Underperformances were detected only in cases where a specific registration strategy is mandatory to obtain a satisfying match. CONCLUSIONS All of the considered algorithms show performances not inferior to previously published data and have the potential to be good candidates for use in the clinical routine. The results and conclusions only apply to the considered phantoms and should not be considered to be generally applicable and extendable to patient cases.
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Romanò C, De Marco P, Trivellato S, Ciardo D, Comi S, Marvaso G, Riva G, Jereczek-Fossa BA, Orecchia R, Cattani F. Influence of different urinary bladder filling levels and controlling regions of interest selection on deformable image registration algorithms. Phys Med 2020; 75:19-25. [PMID: 32473519 DOI: 10.1016/j.ejmp.2020.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/01/2020] [Accepted: 05/12/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Evaluation of Raystation ANAtomically CONstrained Deformation Algorithm (ANACONDA) performance to different urinary bladder filling levels in male pelvis anatomic site varying the controlling Regions Of Interest (ROIs). METHODS Different image datasets were obtained with ImSimQA (Oncology System Limited, Shrewsbury, UK) to evaluate ANACONDA performances (RaySearch Laboratories, Stockholm, Sweden). Deformation vector fields were applied to a synthetic man pelvis and a real patient computed tomography (CT) dataset (reference CTs) resulting in deformed CTs (target CTs) with various bladder filling levels. Different deformable image registrations (DIRs) were generated between each target CTs and reference CTs varying the controlling ROIs subset. Deformed ROIs were mapped from target CT to reference CT and then compared to reference ROIs. Evaluation was performed by Dice Similarity Coefficient (DSC), Correlation Coefficient (CC), Mean Distance to Agreement (MDA), maximum Distance to Agreement (maxDA) and with the introduction of global DSC (global_DSC) and global CC (global_CC) parameters. RESULTS In both synthetic and real patient CT cases, DSC scored less than 0.75 and MDA greater than 3 mm when no ROIs or only bladder were exploited as controlling ROI. DSC and CC increased by increasing the number of controlling ROIs selected whereas, an opposite behavior was observed for MDA and maxDA. CONCLUSIONS ANACONDA performances can be influenced by bladder filling fluctuation if no controlling ROIs are selected. Global_DSC and global_CC are useful parameters to quantitatively compare DIR algorithms. DIR performances improve by increasing the number of controlling ROIs selected, reaching a saturation level after a defined ROIs subset selection.
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Affiliation(s)
- Chiara Romanò
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy; Department of Physics, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.
| | - Paolo De Marco
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Sara Trivellato
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Delia Ciardo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Stefania Comi
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Giulia Riva
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Roberto Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
| | - Federica Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, I 20132 Milan, Italy
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Bohoudi O, Lagerwaard FJ, Bruynzeel AM, Niebuhr NI, Johnen W, Senan S, Slotman BJ, Pfaffenberger A, Palacios MA. End-to-end empirical validation of dose accumulation in MRI-guided adaptive radiotherapy for prostate cancer using an anthropomorphic deformable pelvis phantom. Radiother Oncol 2019; 141:200-207. [DOI: 10.1016/j.radonc.2019.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 10/25/2022]
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17
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Wu RY, Liu AY, Williamson TD, Yang J, Wisdom PG, Zhu XR, Frank SJ, Fuller CD, Gunn GB, Gao S. Quantifying the accuracy of deformable image registration for cone-beam computed tomography with a physical phantom. J Appl Clin Med Phys 2019; 20:92-100. [PMID: 31541526 PMCID: PMC6806467 DOI: 10.1002/acm2.12717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Kilo-voltage cone-beam computed tomography (CBCT) is widely used for patient alignment, contour propagation, and adaptive treatment planning in radiation therapy. In this study, we evaluated the accuracy of deformable image registration (DIR) for CBCT under various imaging protocols with different noise and patient dose levels. METHODS A physical phantom previously developed to facilitate end-to-end testing of the DIR accuracy was used with Varian Velocity v4.0 software to evaluate the performance of image registration from CT to CT, CBCT to CT, and CBCT to CBCT. The phantom is acrylic and includes several inserts that simulate different tissue shapes and properties. Deformations and anatomic changes were simulated by changing the rotations of both the phantom and the inserts. CT images (from a head and neck protocol) and CBCT images (from pelvis, head and "Image Gently" protocols) were obtained with different image noise and dose levels. Large inserts were filled with Mobil DTE oil to simulate soft tissue, and small inserts were filled with bone materials. All inserts were contoured before the DIR process to provide a ground truth contour size and shape for comparison. After the DIR process, all deformed contours were compared with the originals using Dice similarity coefficient (DSC) and mean distance to agreement (MDA). Both large and small volume of interests (VOIs) for DIR volume selection were tested by simulating a DIR process that included whole patient image volume and clinical target volumes (CTV) only (for CTVs propagation). RESULTS For cross-modality DIR registration (CT to CBCT), the DSC were >0.8 and the MDA were <3 mm for CBCT pelvis, and CBCT head protocols. For CBCT to CBCT and CT to CT, the DIR accuracy was improved relative to the cross-modality tests. For smaller VOIs, the DSC were >0.8 and MDA <2 mm for all modalities. CONCLUSIONS The accuracy of DIR depends on the quality of the CBCT image at different dose and noise levels.
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Affiliation(s)
- Richard Y. Wu
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Amy Y. Liu
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Tyler D. Williamson
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Jinzhong Yang
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Paul G. Wisdom
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Xiaorong R. Zhu
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Steven J. Frank
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Clifton D. Fuller
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Gary B. Gunn
- Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Song Gao
- Department of Radiation PhysicsThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
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État des lieux de la radiothérapie adaptative en 2019 : de la mise en place à l’utilisation clinique. Cancer Radiother 2019; 23:581-591. [DOI: 10.1016/j.canrad.2019.07.142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 07/12/2019] [Indexed: 12/20/2022]
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In-vivo treatment accuracy analysis of active motion-compensated liver SBRT through registration of plan dose to post-therapeutic MRI-morphologic alterations. Radiother Oncol 2019; 134:158-165. [PMID: 31005210 DOI: 10.1016/j.radonc.2019.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND/PURPOSE In-vivo-accuracy analysis (IVA) of dose-delivery with active motion-management (gating/tracking) was performed based on registration of post-radiotherapeutic MRI-morphologic-alterations (MMA) to the corresponding dose-distributions of gantry-based/robotic SBRT-plans. METHODS Forty targets in two patient cohorts were evaluated: (1) gantry-based SBRT (deep-inspiratory breath-hold-gating; GS) and (2) robotic SBRT (online fiducial-tracking; RS). The planning-CT was deformably registered to the first post-treatment contrast-enhanced T1-weighted MRI. An isodose-structure cropped to the liver (ISL) and corresponding to the contoured MMA was created. Structure and statistical analysis regarding volumes, surface-distance, conformity metrics and center-of-mass-differences (CoMD) was performed. RESULTS Liver volume-reduction was -43.1 ± 148.2 cc post-RS and -55.8 ± 174.3 cc post-GS. The mean surface-distance between MMA and ISL was 2.3 ± 0.8 mm (RS) and 2.8 ± 1.1 mm (GS). ISL and MMA volumes diverged by 5.1 ± 23.3 cc (RS) and 16.5 ± 34.1 cc (GS); the median conformity index of both structures was 0.83 (RS) and 0.80 (GS). The average relative directional errors were ≤0.7 mm (RS) and ≤0.3 mm (GS); the median absolute 3D-CoMD was 3.8 mm (RS) and 4.2 mm (GS) without statistically significant differences between the two techniques. Factors influencing the IVA included GTV and PTV (p = 0.041 and p = 0.020). Four local relapses occurred without correlation to IVA. CONCLUSIONS For the first time a method for IVA was presented, which can serve as a benchmarking-tool for other treatment techniques. Both techniques have shown median deviations <5 mm of planned dose and MMA. However, IVA also revealed treatments with errors ≥5 mm, suggesting a necessity for patient-specific safety-margins. Nevertheless, the treatment accuracy of well-performed active motion-compensated liver SBRT seems not to be a driving factor for local treatment failure.
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Dolde K, Dávid C, Echner G, Floca R, Hentschke C, Maier F, Niebuhr N, Ohmstedt K, Saito N, Alimusaj M, Fluegel B, Naumann P, Dreher C, Freitag M, Pfaffenberger A. 4DMRI-based analysis of inter— and intrafractional pancreas motion and deformation with different immobilization devices. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/aaf9ae] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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