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Archawametheekul K, Puttanawarut C, Suphaphong S, Jiarpinitnun C, Sakulsingharoj S, Stansook N, Khachonkham S. The Investigating Image Registration Accuracy and Contour Propagation for Adaptive Radiotherapy Purposes in Line with the Task Group No. 132 Recommendation. J Med Phys 2024; 49:64-72. [PMID: 38828076 PMCID: PMC11141753 DOI: 10.4103/jmp.jmp_168_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: 12/07/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose Image registration is a crucial component of the adaptive radiotherapy workflow. This study investigates the accuracy of the deformable image registration (DIR) and contour propagation features of SmartAdapt, an application in the Eclipse treatment planning system (TPS) version 16.1. Materials and Methods The registration accuracy was validated using the Task Group No. 132 (TG-132) virtual phantom, which features contour evaluation and landmark analysis based on the quantitative criteria recommended in the American Association of Physicists in Medicine TG-132 report. The target registration error, Dice similarity coefficient (DSC), and center of mass displacement were used as quantitative validation metrics. The performance of the contour propagation feature was evaluated using clinical datasets (head and neck, pelvis, and chest) and an additional four-dimensional computed tomography (CT) dataset from TG-132. The primary planning and the second CT images were appropriately registered and deformed. The DSC was used to find the volume overlapping between the deformed contours and the radiation oncologist (RO)-drawn contour. The clinical value of the DIR-generated structure was reviewed and scored by an experienced RO to make a qualitative assessment. Results The registration accuracy fell within the specified tolerances. SmartAdapt exhibited a reasonably propagated contour for the chest and head-and-neck regions, with DSC values of 0.80 for organs at risk. Misregistration is frequently observed in the pelvic region, which is specified as a low-contrast region. However, 78% of structures required no modification or minor modification, demonstrating good agreement between contour comparison and the qualitative analysis. Conclusions SmartAdapt has adequate efficiency for image registration and contour propagation for adaptive purposes in various anatomical sites. However, there should be concern about its performance in regions with low contrast and small volumes.
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Affiliation(s)
- Kamonchanok Archawametheekul
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chanon Puttanawarut
- Chakri Naruebodindra Medical Institute, Mahidol University, Samut Prakan, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sithiphong Suphaphong
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chuleeporn Jiarpinitnun
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Siwaporn Sakulsingharoj
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nauljun Stansook
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suphalak Khachonkham
- Division of Radiation Oncology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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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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Ayadi M, Dupuis P, Baudier T, Padovani L, Sarrut D, Sunyach MP. Management of reirradiations: A clinical and technical overview based on a French survey. Phys Med 2023; 109:102582. [PMID: 37080157 DOI: 10.1016/j.ejmp.2023.102582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/22/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The reirradiation number increased due to systemic therapies and patient survival. Few guidelines regarding acceptable cumulative doses to organs at risk (OARs) and appropriate dose accumulation tools need, made reirradiation challenging. The survey objective was to present the French current technical and clinical practices in reirradiations. METHODS A group of physician and physicists developed a survey gathering major issues of the topic. The questionnaire consisted in 4 parts: data collection, demographic, clinical and technical aspects. It was delivered through the SFRO and the SFPM. Data collection lasted 2 months and were gathered to compute statistical analysis. RESULTS 48 institutions answered the survey. Difficulties about patient data collection were related to patient safety, administrative and technical limitations. Half of the institutions discussed reirradiation cases during a multidisciplinary meeting. It mainly aimed at discussing the indication and the new treatment total dose (92%). 79% of the respondents used various references but only 6% of them were specific to reirradiations. Patients with pain and clinical deficit were ranked as best inclusion criteria. 54.2% of the institutions considered OARs recovery, especially for spinal cord and brainstem. A commercial software was used for dose accumulation for 52% of respondents. Almost all institutions performed equivalent dose conversion (94%). A quarter of the institutions estimated not to have the appropriate equipment for reirradiation. CONCLUSION This survey showed the various approaches and tools used in reirradiation management. It highlighted issues in collecting data, and the guidelines necessity for safe practices, to increase clinicians confidence in retreating patients.
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Affiliation(s)
- Myriam Ayadi
- Radiation Therapy Department, Léon Bérard Centre, Lyon, France.
| | - Pauline Dupuis
- Radiation Therapy Department, Léon Bérard Centre, Lyon, France
| | - Thomas Baudier
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm, Centre Léon Bérard, CREATIS UMR 5220, U1206, F-69373 Lyon, France
| | - Laeticia Padovani
- Radiotherapy Department, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - David Sarrut
- Univ Lyon, INSA-Lyon, Université Lyon 1, CNRS, Inserm, Centre Léon Bérard, CREATIS UMR 5220, U1206, F-69373 Lyon, France
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Kadoya N. [[Radiation Therapy] 4. Development of Physical Phantom for Deformable Image Registration in Radiotherapy]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:179-186. [PMID: 36804808 DOI: 10.6009/jjrt.2023-2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Noriyuki Kadoya
- Radiation Oncology, Tohoku University Graduate School of Medicine
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Sakulsingharoj S, Kadoya N, Tanaka S, Sato K, Nakamura M, Jingu K. Dosimetric impact of deformable image registration using radiophotoluminescent glass dosimeters with a physical geometric phantom. J Appl Clin Med Phys 2023; 24:e13890. [PMID: 36609786 PMCID: PMC10113686 DOI: 10.1002/acm2.13890] [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: 08/09/2022] [Revised: 11/04/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To study the dosimetry impact of deformable image registration (DIR) using radiophotoluminescent glass dosimeter (RPLD) and custom developed phantom with various inserts. METHODS The phantom was developed to facilitate simultaneous evaluation of geometric and dosimetric accuracy of DIR. Four computed tomography (CT) images of the phantom were acquired with four different configurations. Four volumetric modulated arc therapy (VMAT) plans were computed for different phantom. Two different patterns were applied to combination of four phantom configurations. RPLD dose measurement was combined between corresponding two phantom configurations. DIR-based dose accumulation was calculated between corresponding two CT images with two commercial DIR software and various DIR parameter settings, and an open source software. Accumulated dose calculated using DIR was then compared with measured dose using RPLD. RESULTS The mean ± standard deviation (SD) of dose difference was 2.71 ± 0.23% (range, 2.22%-3.01%) for tumor-proxy and 3.74 ± 0.79% (range, 1.56%-4.83%) for rectum-proxy. The mean ± SD of target registration error (TRE) was 1.66 ± 1.36 mm (range, 0.03-4.43 mm) for tumor-proxy and 6.87 ± 5.49 mm (range, 0.54-17.47 mm) for rectum-proxy. These results suggested that DIR accuracy had wide range among DIR parameter setting. CONCLUSIONS The dose difference observed in our study was 3% for tumor-proxy and within 5% for rectum-proxy. The custom developed physical phantom with inserts showed potential for accurate evaluation of DIR-based dose accumulation. The prospect of simultaneous evaluation of geometric and dosimetric DIR accuracy in a single phantom may be useful for validation of DIR for clinical use.
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Affiliation(s)
- Siwaporn Sakulsingharoj
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Radiation Oncology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shohei Tanaka
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyokazu Sato
- Department of Radiation Technology, Tohoku University Hospital, Sendai, Japan
| | - Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto, Japan.,Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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