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Naser MA, Wahid KA, Ahmed S, Salama V, Dede C, Edwards BW, Lin R, McDonald B, Salzillo TC, He R, Ding Y, Abdelaal MA, Thill D, O'Connell N, Willcut V, Christodouleas JP, Lai SY, Fuller CD, Mohamed ASR. Quality assurance assessment of intra-acquisition diffusion-weighted and T2-weighted magnetic resonance imaging registration and contour propagation for head and neck cancer radiotherapy. Med Phys 2023; 50:2089-2099. [PMID: 36519973 PMCID: PMC10121748 DOI: 10.1002/mp.16128] [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: 12/21/2021] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Adequate image registration of anatomical and functional magnetic resonance imaging (MRI) scans is necessary for MR-guided head and neck cancer (HNC) adaptive radiotherapy planning. Despite the quantitative capabilities of diffusion-weighted imaging (DWI) MRI for treatment plan adaptation, geometric distortion remains a considerable limitation. Therefore, we systematically investigated various deformable image registration (DIR) methods to co-register DWI and T2-weighted (T2W) images. MATERIALS/METHODS We compared three commercial (ADMIRE, Velocity, Raystation) and three open-source (Elastix with default settings [Elastix Default], Elastix with parameter set 23 [Elastix 23], Demons) post-acquisition DIR methods applied to T2W and DWI MRI images acquired during the same imaging session in twenty immobilized HNC patients. In addition, we used the non-registered images (None) as a control comparator. Ground-truth segmentations of radiotherapy structures (tumour and organs at risk) were generated by a physician expert on both image sequences. For each registration approach, structures were propagated from T2W to DWI images. These propagated structures were then compared with ground-truth DWI structures using the Dice similarity coefficient and mean surface distance. RESULTS 19 left submandibular glands, 18 right submandibular glands, 20 left parotid glands, 20 right parotid glands, 20 spinal cords, and 12 tumours were delineated. Most DIR methods took <30 s to execute per case, with the exception of Elastix 23 which took ∼458 s to execute per case. ADMIRE and Elastix 23 demonstrated improved performance over None for all metrics and structures (Bonferroni-corrected p < 0.05), while the other methods did not. Moreover, ADMIRE and Elastix 23 significantly improved performance in individual and pooled analysis compared to all other methods. CONCLUSIONS The ADMIRE DIR method offers improved geometric performance with reasonable execution time so should be favoured for registering T2W and DWI images acquired during the same scan session in HNC patients. These results are important to ensure the appropriate selection of registration strategies for MR-guided radiotherapy.
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Affiliation(s)
- Mohamed A Naser
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kareem A Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sara Ahmed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Vivian Salama
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cem Dede
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Benjamin W Edwards
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ruitao Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Brigid McDonald
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Travis C Salzillo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Renjie He
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yao Ding
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Moamen Abobakr Abdelaal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | | | | | | | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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2
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Suitability of propagated contours for adaptive replanning for head and neck radiotherapy. Phys Med 2022; 102:66-72. [DOI: 10.1016/j.ejmp.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 11/20/2022] Open
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Utility of deformable image registration for adaptive prostate cancer treatment. Analysis and comparison of two commercially available algorithms. Z Med Phys 2021; 32:369-377. [PMID: 34906406 PMCID: PMC9948872 DOI: 10.1016/j.zemedi.2021.10.001] [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: 07/13/2021] [Revised: 09/24/2021] [Accepted: 10/17/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to assess and compare the capabilities of two commercially available deformable image registration algorithms implemented in Raystation 9A (A1) and Velocity AI (A2) for possible usage in adaptive prostate radiotherapy based on the propagation of anatomical contours from computed tomography (CT) images to cone-beam CT (CBCT) images. MATERIAL AND METHODS Ten patients were retrospectively selected from a group treated for localized prostate cancer. The propagation of rectum contours was analyzed in a set of CT-CBCT pairs. Two independent observers carried out qualitative analysis using the two-level descriptive scale (meet/fail). Quantitative analysis was done using landmark points distances based on implanted markers as navigation points and differently obtained contours (manually and automatically using DIR algorithms). Quantitative analysis was taken on sets preselected by qualitative analysis. RESULTS Qualitative analysis shows that 83.7% of the rectum contours were scored identically (meet or fail) for both algorithms, from which 53.5% and 55.8% are failed results for A1 and A2, respectively. For the rectum size (RWD parameter), differences between referenced and deformation-based values were 5.5 and 5.8mm, and for the rectum wall, the prostate marker distance (WMD parameter) was 4.5 and 5.5mm for A1 and A2, respectively. The differences between the WMD parameters were statistically significant (p=0.007). CONCLUSIONS In both tested algorithms, neither effectiveness nor measured uncertainties in the propagation of rectum contour process in prostate patient cases were satisfactory. Careful selection of input images followed by case/set-based verification of every deformable registration is a substantial step to avoid inappropriate results.
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Marcuse F, Peeters S, Herman K, Vaassen F, van Elmpt W, Maat APWM, Praag J, Billiet C, Van Schil P, Lambrecht M, Van Raemdonck D, Cao K, Grigoroiu M, Girard N, Hochstenbag M, Maessen J, De Ruysscher D. Optimal delineation of the clinical target volume for thymomas in the post-resection setting: A multi-center study. Radiother Oncol 2021; 165:8-13. [PMID: 34673091 DOI: 10.1016/j.radonc.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The definition of the clinical target volume (CTV) for post-operative radiotherapy (PORT) for thymoma is largely unexplored. The aim of this study was to analyze the difference in CTV delineation between radiation oncologists (RTO) and surgeons. METHODS This retrospective multi-center study enrolled 31 patients who underwent PORT for a thymoma from five hospitals. Three CTVs were delineated per patient: one CTV by the RTO, one CTV by the surgeon (blinded to the results of the RTO) and a joint CTV after collaboration. Volumes (cm3), Hausdorff distances (HD) and Dice similarity coefficients (DSC) were analyzed. RESULTS RTO delineated significantly bigger CTVs than surgeons (mean: 93.9 ± 63.1, versus 57.9 ± 61.3 cm3, p = 0.003). Agreement was poor between RO and surgeons, with a low mean DSC (0.34 ± 0.21) and high mean HD of 4.5 (±2.2) cm. Collaborative delineation resulted in significantly smaller volumes compared to RTO (mean 57.1 ± 58.6 cm3, p < 0.001). A mean volume of 18.9 (±38.1) cm3 was included in joint contours, but missed by RTO. Conversely, a mean volume of 55.7 (±39.9) cm3 was included in RTO's delineations, but not in the joint delineations. CONCLUSIONS To the best of our knowledge, this is the first study investigating CTV definition in thymoma. We demonstrated a significant variability between RTO and surgeons. Joint delineation prompted revisions in smaller CTV as well as favoring the surgeons' judgement, suggesting that surgeons provided relevant insight into other risk areas than RTO. We recommend a multidisciplinary approach to PORT for thymomas in clinical practice.
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Affiliation(s)
- Florit Marcuse
- Department of Pulmonology, Maastricht University Medical Center+, the Netherlands.
| | - Stephanie Peeters
- Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands
| | - Kato Herman
- Department of Pulmonology, Maastricht University Medical Center+, the Netherlands
| | - Femke Vaassen
- Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands
| | - Wouter van Elmpt
- Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands
| | - Alexander P W M Maat
- Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - John Praag
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Charlotte Billiet
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, University of Antwerp, Belgium
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital and Antwerp University, Belgium
| | - Maarten Lambrecht
- Department of Radiation Oncology, University Hospitals Leuven/KU Leuven, Belgium
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven/KU Leuven, Belgium
| | - Kim Cao
- Department of Radiation Oncology, L'Institut du Thorax Curie-Montsouris, Paris, France
| | - Madalina Grigoroiu
- Department of Thoracic Surgery, L'Institut du Thorax Curie-Montsouris, Paris, France
| | - Nicolas Girard
- Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; UVSQ, Paris Saclay, Versailles, France
| | - Monique Hochstenbag
- Department of Pulmonology, Maastricht University Medical Center+, the Netherlands
| | - Jos Maessen
- Department of Cardiothoracic Surgery, Maastricht University Medical Center+, the Netherlands
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands
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Oulhouq Y, Bakari D, Krim DE, Zerfaoui M, Rrhioua A, Berhili S, Mezouar L. Dosimetric study of Hounsfield number correction effect in areas influenced by contrast product in lungs case. Rep Pract Oncol Radiother 2021; 26:590-597. [PMID: 34434575 PMCID: PMC8382071 DOI: 10.5603/rpor.a2021.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/27/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The aim of the study was dosimetric effect quantification of exclusive computed tomography (CT) use with an intravenous (IV) contrast agent (CA ), on dose distribution of 3D-CRT treatment plans for lung cancer. Furthermore, dosimetric advantage investigation of manually contrast-enhanced region overriding, especially the heart. MATERIALS AND METHODS Ten patients with lung cancer were considered. For each patient two planning CT sets were initially taken with and without CA. Treatment planning were optimized based on CT scans without CA. All plans were copied and recomputed on scans with CA. In addition, scans with IV contrast were copied and density correction was performed for heart contrast enhanced. Same plans were copied and replaced to undo dose calculation errors that may be caused by CA. Eventually, dosimetric evaluations based on dose volume histograms (DVHs) of planning target volumes (PTV) and organs at-risk were studied and analyzed using the Wilcoxon's signed rank test. RESULTS There is no statistically significant difference in dose calculation for the PTV maximum, mean, minimum doses, spinal cord maximum doses and lung volumes that received 20 and 30 Gy, between planes calculated with and without contrast scans (p > 0.05) and also for contrast scan, with manual regions overriding. CONCLUSIONS Dose difference caused by the contrast agent is negligible and not significant. Therefore, there is no justification to perform two scans, and using an IV contrast enhanced scan for dose calculation is sufficient.
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Affiliation(s)
- Yassine Oulhouq
- LPMR, Faculty of Sciences, University Mohamed 1st, Oujda, Morocco,HASSAN II Oncology Center, University Hospital Mohammed VI, Oujda, Morocco
| | - Dikra Bakari
- National School of Applied Sciences, University Mohamed 1st, Oujda, Morocco
| | - Deae-Eddine Krim
- LPMR, Faculty of Sciences, University Mohamed 1st, Oujda, Morocco
| | | | - Abdeslem Rrhioua
- LPMR, Faculty of Sciences, University Mohamed 1st, Oujda, Morocco
| | - Soufiane Berhili
- HASSAN II Oncology Center, University Hospital Mohammed VI, Oujda, Morocco
| | - Loubna Mezouar
- HASSAN II Oncology Center, University Hospital Mohammed VI, Oujda, Morocco
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6
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Shi L, Chen Q, Barley S, Cui Y, Shang L, Qiu J, Rong Y. Benchmarking of Deformable Image Registration for Multiple Anatomic Sites Using Digital Data Sets With Ground-Truth Deformation Vector Fields. Pract Radiat Oncol 2021; 11:404-414. [PMID: 33722783 DOI: 10.1016/j.prro.2021.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/27/2021] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to evaluate the accuracy of deformable image registration (DIR) algorithms using data sets with different levels of ground-truth deformation vector fields (DVFs) and to investigate the correlation between DVF errors and contour-based metrics. METHODS AND MATERIALS Nine pairs of digital data sets were generated through contour-controlled deformations based on 3 anonymized patients' CTs (head and neck, thorax/abdomen, and pelvis) with low, medium, and high deformation intensity for each site using the ImSimQA software. Image pairs and their associated contours were imported to MIM-Maestro, Raystation, and Velocity systems, followed by DIR and contour propagation. The system-generated DVF and propagated contours were compared with the ground-truth data. The correlation between DVF errors and contour-based metrics was evaluated using the Pearson correlation coefficient (r), while their correlation with volumes were calculated using Spearman correlation coefficient (rho). RESULTS The DVF errors increased with increasing deformation intensity. All DIR algorithms performed well for esophagus, trachea, left femoral, right femoral, and urethral (mean and maximum DVF errors <2.50 mm and <4.27 mm, respectively; Dice similarity coefficient: 0.93-0.99). Brain, liver, left lung, and bladder showed large DVF errors for all 3 systems (dmax: 2.8-91.90 mm). The minimum and maximum DVF errors, conformity index, and Dice similarity coefficient were correlated with volumes (|rho|: 0.41-0.64), especially for very large or small structures (|rho|: 0.64-0.80). Only mean distance to agreement of Raystation and Velocity correlated with some indices of DVF errors (r: 0.70-0.78). CONCLUSIONS Most contour-based metrics had no correlation with DVF errors. For adaptive radiation therapy, well-performed contour propagation does not directly indicate accurate dose deformation and summation/accumulation within each contour (determined by DVF accuracy). Tolerance values for DVF errors should vary as the acceptable accuracy for overall adaptive radiation therapy depends on anatomic site, deformation intensity, organ size, and so forth. This study provides benchmark tables for evaluating DIR accuracy in various clinical scenarios.
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Affiliation(s)
- Liting Shi
- Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, California; School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China; Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, China
| | - Quan Chen
- Department of Radiation Oncology, University of Kentucky, Lexington, Kentucky
| | - Susan Barley
- Oncology Systems Limited (OSL), Shrewsbury, Shropshire, United Kingdom
| | - Yunfeng Cui
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Lu Shang
- Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, California
| | - Jianfeng Qiu
- Medical Engineering and Technology Research Center; Imaging-X Joint Laboratory; Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Yi Rong
- Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, California; Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona.
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Irmak S, Georg D, Lechner W. Comparison of CBCT conversion methods for dose calculation in the head and neck region. Z Med Phys 2020; 30:289-299. [PMID: 32620322 DOI: 10.1016/j.zemedi.2020.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/28/2020] [Accepted: 05/26/2020] [Indexed: 01/21/2023]
Abstract
The purpose of this study was to compare different methods of CBCT conversion respect to dose calculation accuracy. Twelve head and neck cancer patients treated with VMAT using simultaneous integrated boost technique were selected for the study. For each patient a planning CT (pCT), a control. CT acquired in the fourth week of treatment and a CBCT scan acquired on the closest day with the control CT were used. In order to re-calculate dose directly on CBCT image sets, a population based approach (CBCTPop) and a Histogram Matching (HM) approach based on rigid (CBCTHM-R) and deformable registration (CBCTHM-D) were used. Additionally, virtual CTs (vCTs) were generated using two deformable image registration algorithms (CTELX and CTANC) of the planning CT to the CBCT by using two different deformable image registration (DIR) algorithms. The corresponding control CTs were selected as ground truth and dose distributions on CBCT were analyzed using 3D global gamma index analysis applying a threshold of 10% with respect to the prescribed dose. Using the 2%/2mm gamma criterion, the results were 89.9%(±8.3%), 94.1%(±5.0%), 94.3%(±5.7%), 96.1%(±3.9%), 93.4%(±6.3%) for the CBCTPop, CBCTHM-R, CBCTHM-D, CTELX and CTANC, respectively. On average, the HM and DIR techniques showed a higher accuracy compared to the population based approach, but Kruskal-Wallis test did not show significant difference among the investigated dose calculation techniques assuming p<0.05. More sophisticated CBCT dose calculation methods seem to improve the dose calculation accuracy, but statistical significance remains to be demonstrated.
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Affiliation(s)
- Sinan Irmak
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Dietmar Georg
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Lechner
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
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MRI based volumetric measurements of vestibular schwannomas in patients with neurofibromatosis type 2: comparison of three different software tools. Sci Rep 2020; 10:11541. [PMID: 32665659 PMCID: PMC7360562 DOI: 10.1038/s41598-020-68489-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 06/25/2020] [Indexed: 11/08/2022] Open
Abstract
Neurofibromatosis type 2 is a neurogenetic disorder with an incidence of about 1:33.000. Hallmarks are bilateral benign vestibular schwannomas, which can lead to deafness or brainstem compression. Volumetric tumor measurements are essential to assess the efficacy of new therapies. We present a statistical and methodical comparison of three volumetric image analysis tools. We performed volumetric measurements on phantoms with predefined volumes (0.1 to 8.0 ml) and tumors seen on 32 head MRI scans from eight NF2 patients with BrainLab, ITK-Snap, or OsiriX. The software was compared with regard to accuracy and reproducibility of the measurements and time required for analysis. The mean volume estimated by all three software programs differed significantly from the true volume of the phantoms, but OsiriX and BrainLab gave estimates that were not significantly different from each other. For the actual tumors, the estimated volumes with all three software tools showed a low coefficient of variability, but the mean volume estimates differed among the tools. OsiriX showed the shortest analysis time. Volumetric assessment of MRI images is associated to an intrinsic risk of miscalculation. For precise volumes it is mandatory to use the same volumetric tools for all measurements.
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9
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Calusi S, Labanca G, Zani M, Casati M, Marrazzo L, Noferini L, Talamonti C, Fusi F, Desideri I, Bonomo P, Livi L, Pallotta S. A multiparametric method to assess the MIM deformable image registration algorithm. J Appl Clin Med Phys 2019; 20:75-82. [PMID: 30924286 PMCID: PMC6448167 DOI: 10.1002/acm2.12564] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/19/2019] [Accepted: 02/25/2019] [Indexed: 11/07/2022] Open
Abstract
A quantitative evaluation of the performances of the deformable image registration (DIR) algorithm implemented in MIM-Maestro was performed using multiple similarity indices. Two phantoms, capable of mimicking different anatomical bending and tumor shrinking were built and computed tomography (CT) studies were acquired after applying different deformations. Three different contrast levels between internal structures were artificially created modifying the original CT values of one dataset. DIR algorithm was applied between datasets with increasing deformations and different contrast levels and manually refined with the Reg Refine tool. DIR algorithm ability in reproducing positions, volumes, and shapes of deformed structures was evaluated using similarity indices such as: landmark distances, Dice coefficients, Hausdorff distances, and maximum diameter differences between segmented structures. Similarity indices values worsen with increasing bending and volume difference between reference and target image sets. Registrations between images with low contrast (40 HU) obtain scores lower than those between images with high contrast (970 HU). The use of Reg Refine tool leads generally to an improvement of similarity parameters values, but the advantage is generally less evident for images with low contrast or when structures with large volume differences are involved. The dependence of DIR algorithm on image deformation extent and different contrast levels is well characterized through the combined use of multiple similarity indices.
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Affiliation(s)
- Silvia Calusi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giusy Labanca
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Margherita Zani
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Marta Casati
- Medical Physics Unit, AOU Careggi, Florence, Italy
| | | | | | - Cinzia Talamonti
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Physics Unit, AOU Careggi, Florence, Italy
| | - Franco Fusi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Isacco Desideri
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Radiation Therapy Unit, AOU Careggi, Florence, Italy
| | | | - Lorenzo Livi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Radiation Therapy Unit, AOU Careggi, Florence, Italy
| | - Stefania Pallotta
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Physics Unit, AOU Careggi, Florence, Italy
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Figl M, Hoffmann R, Kaar M, Hummel J. Deformable registration of 3D ultrasound volumes using automatic landmark generation. PLoS One 2019; 14:e0213004. [PMID: 30875379 PMCID: PMC6420033 DOI: 10.1371/journal.pone.0213004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 02/13/2019] [Indexed: 11/18/2022] Open
Abstract
US image registration is an important task e.g. in Computer Aided Surgery. Due to tissue deformation occurring between pre-operative and interventional images often deformable registration is necessary. We present a registration method focused on surface structures (i.e. saliencies) of soft tissues like organ capsules or vessels. The main concept follows the idea of representative landmarks (so called leading points). These landmarks represent saliencies in each image in a certain region of interest. The determination of deformation was based on a geometric model assuming that saliencies could locally be described by planes. These planes were calculated from the landmarks using two dimensional linear regression. Once corresponding regions in both images were found, a displacement vector field representing the local deformation was computed. Finally, the deformed image was warped to match the pre-operative image. For error calculation we used a phantom representing the urinary bladder and the prostate. The phantom could be deformed to mimic tissue deformation. Error calculation was done using corresponding landmarks in both images. The resulting target registration error of this procedure amounted to 1.63 mm. With respect to patient data a full deformable registration was performed on two 3D-US images of the abdomen. The resulting mean distance error was 2.10 ± 0.66 mm compared to an error of 2.75 ± 0.57 mm from a simple rigid registration. A two-sided paired t-test showed a p-value < 0.001. We conclude that the method improves the results of the rigid registration considerably. Provided an appropriate choice of the filter there are many possible fields of applications.
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Affiliation(s)
- Michael Figl
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Rainer Hoffmann
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Marcus Kaar
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Johann Hummel
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- * E-mail:
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Inter-observer variability of clinical target volume delineation in definitive radiotherapy of neck lymph node metastases from unknown primary. A cooperative study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Group. Radiol Med 2019; 124:682-692. [PMID: 30852793 DOI: 10.1007/s11547-019-01006-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/11/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study, promoted by Italian Association of Radiotherapy and Clinical Oncology (AIRO) Head and Neck Group, aimed to assess the current national practice of target volume delineation on a case of neck lymph node metastases from unknown primary evaluating inter-observer variability, in a setting of primary radiotherapy. MATERIALS AND METHODS A case of metastatic neck lymph node from occult primary was proposed to 17 radiation oncologists. A national reference RT center was identified and considered as benchmark. Participants were requested to delineate target volumes. A structured questionnaire was administered. A comparison between following parameters of the CTVs was performed: centroids distances, Dice similarity index (DSI), Jaccard index and mean distance to agreement (MDA). Volume expressed in cubic centimeters and CTVs cranio-caudal extension were evaluated. RESULTS Sixteen of 17 radiation oncologists recommended three CTVs dose levels. (CTV HD, CTV ID and CTV LD); CTV ID was not delineated by one of the participants and by the reference center. The distance between the reference centroid and the mean centroid of CTVs HD was 1.09 cm (0.36-3.99 cm); for CTV LD, a mean centroids distance of 2.45 (0.27-4.83 cm) was found, and for CTV HD, mean DSI is 0.48 and mean Jaccard index is 0.32 and MDA was 8.89 mm. CTV LD showed a mean DSI of 0.46, mean Jaccard index of 0.31 and MDA of 14.87 when compared to the reference. CONCLUSION Many aspects concerning treatment optimization of cervical nodes metastases from occult primary remain unclear, and we found a notable heterogeneity of global radiotherapy management reporting discordances both in target volume delineation and volume prescription.
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Gupta V, Wang Y, Méndez Romero A, Myronenko A, Jordan P, Maurer C, Heijmen B, Hoogeman M. Fast and robust adaptation of organs-at-risk delineations from planning scans to match daily anatomy in pre-treatment scans for online-adaptive radiotherapy of abdominal tumors. Radiother Oncol 2018. [DOI: 10.1016/j.radonc.2018.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Buschmann M, Majercakova K, Sturdza A, Smet S, Najjari D, Daniel M, Pötter R, Georg D, Seppenwoolde Y. Image guided adaptive external beam radiation therapy for cervix cancer: Evaluation of a clinically implemented plan-of-the-day technique. Z Med Phys 2017; 28:184-195. [PMID: 29031916 DOI: 10.1016/j.zemedi.2017.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Radiotherapy for cervix cancer is challenging in patients exhibiting large daily changes in the pelvic anatomy, therefore adaptive treatments (ART) have been proposed. The aim of this study was the clinical implementation and subsequent evaluation of plan-of-the-day (POTD)-ART for cervix cancer in supine positioning. The described workflow was based on standard commercial equipment and current quality assurance (QA) methods. MATERIALS AND METHODS A POTD strategy, which employs a VMAT plan library consisting of an empty bladder plan, a full bladder plan and a motion robust backup plan, was developed. Daily adaption was guided by cone beam computed tomography (CBCT) imaging after which the best plan from the library was selected. Sixteen patients were recruited in a clinical study on ART, for nine POTD was applied due to their large organ motion derived from two computed tomography (CT) scans with variable bladder filling. All patients were treated to 45Gy in 25 fractions. Plan selection frequencies over the treatment course were analyzed. Daily doses in the rectum, bladder and cervix-uterus target (CTV-T) were derived and compared to a simulated non-adapted treatment (non-ART), which employed the robust plan for each fraction. Additionally, the adaption consistency was determined by repeating the plan selection procedure one month after treatment by a group of experts. ART-specific QA methods are presented. RESULTS 225 ART fractions with CBCTs were analyzed. The empty bladder plan was delivered in 49% of the fractions in the first treatment week and this number increased to 78% in the fifth week. The daily coverage of the CTV-T was equivalent between ART and the non-ART simulation, while the daily total irradiated volume V42.75Gy (95% of prescription dose) was reduced by a median of 87cm3. The median delivered V42.75Gy was 1782cm3. Daily delivered doses (V42.75Gy, V40Gy, V30G) to the organs at risk were statistically significantly reduced by ART, with a median difference in daily V42.75Gy in rectum and bladder of 3.2% and 1.1%, respectively. The daily bladder V42.75Gy and V40Gy were decreased by more than 10 percent points in 30% and 24% of all fractions, respectively, through ART. The agreement between delivered plans and retrospective expert-group plan selections was 84%. CONCLUSION A POTD-ART technique for cervix cancer was successfully and safely implemented in the clinic and evaluated. Improved normal tissue sparing compared to a simulated non-ART treatment could be demonstrated. Future developments should focus on commercial automated software solutions to allow for a more widespread adoption and to keep the increased workload manageable.
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Affiliation(s)
- Martin Buschmann
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria.
| | - Katarina Majercakova
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
| | - Alina Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria
| | - Stephanie Smet
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria
| | - Dina Najjari
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria
| | - Michaela Daniel
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
| | - Richard Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria
| | - Dietmar Georg
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
| | - Yvette Seppenwoolde
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria
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Neylon J, Min Y, Low DA, Santhanam A. A neural network approach for fast, automated quantification of DIR performance. Med Phys 2017; 44:4126-4138. [DOI: 10.1002/mp.12321] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 04/13/2017] [Accepted: 04/30/2017] [Indexed: 02/03/2023] Open
Affiliation(s)
- John Neylon
- Department of Radiation Oncology UCLA 200 Medical Plaza, Suite B265 Los Angeles CA 90095 USA
| | - Yugang Min
- Department of Radiation Oncology UCLA 200 Medical Plaza, Suite B265 Los Angeles CA 90095 USA
| | - Daniel A. Low
- Department of Radiation Oncology UCLA 200 Medical Plaza, Suite B265 Los Angeles CA 90095 USA
| | - Anand Santhanam
- Department of Radiation Oncology UCLA 200 Medical Plaza, Suite B265 Los Angeles CA 90095 USA
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Abdoli M, Van Kranen SR, Stankovic U, Rossi MMG, Belderbos JSA, Sonke JJ. Mitigating differential baseline shifts in locally advanced lung cancer patients using an average anatomy model. Med Phys 2017; 44:3570-3578. [DOI: 10.1002/mp.12271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/23/2016] [Accepted: 03/20/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mehrsima Abdoli
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
| | - Simon R. Van Kranen
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
| | - Uros Stankovic
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
| | - Maddalena M. G. Rossi
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
| | - Jose S. A. Belderbos
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
| | - Jan-Jakob Sonke
- Department of Radiation Oncology; Netherlands Cancer Institute; Amsterdam 1066 CX The Netherlands
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Thengumpallil S, Germond JF, Bourhis J, Bochud F, Moeckli R. Impact of respiratory-correlated CT sorting algorithms on the choice of margin definition for free-breathing lung radiotherapy treatments. Radiother Oncol 2016; 119:438-43. [DOI: 10.1016/j.radonc.2016.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/14/2016] [Accepted: 03/19/2016] [Indexed: 10/22/2022]
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Wong VYW, Baker CR, Leung TW, Tung SY. A design of a DICOM-RT-based tool box for nonrigid 4D dose calculation. J Appl Clin Med Phys 2016; 17:99-111. [PMID: 27074476 PMCID: PMC5875557 DOI: 10.1120/jacmp.v17i2.5935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/25/2015] [Accepted: 11/13/2015] [Indexed: 11/23/2022] Open
Abstract
The study was aimed to introduce a design of a DICOM-RT-based tool box to facilitate 4D dose calculation based on deformable voxel-dose registration. The computational structure and the calculation algorithm of the tool box were explicitly discussed in the study. The tool box was written in MATLAB in conjunction with CERR. It consists of five main functions which allow a) importation of DICOM-RT-based 3D dose plan, b) deformable image registration, c) tracking voxel doses along breathing cycle, d) presentation of temporal dose distribution at different time phase, and e) derivation of 4D dose. The efficacy of using the tool box for clinical application had been verified with nine clinical cases on retrospective-study basis. The logistic and the robustness of the tool box were tested with 27 applications and the results were shown successful with no computational errors encountered. In the study, the accumulated dose coverage as a function of planning CT taken at end-inhale, end-exhale, and mean tumor position were assessed. The results indicated that the majority of the cases (67%) achieved maximum target coverage, while the planning CT was taken at the temporal mean tumor position and 56% at the end-exhale position. The comparable results to the literature imply that the studied tool box can be reliable for 4D dose calculation. The authors suggest that, with proper application, 4D dose calculation using deformable registration can provide better dose evaluation for treatment with moving target.
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Ahunbay EE, Li XA. Gradient maintenance: A new algorithm for fast online replanning. Med Phys 2015; 42:2863-76. [DOI: 10.1118/1.4919847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Góra J, Kuess P, Stock M, Andrzejewski P, Knäusl B, Paskeviciute B, Altorjai G, Georg D. ART for head and neck patients: On the difference between VMAT and IMPT. Acta Oncol 2015; 54:1166-74. [PMID: 25850583 DOI: 10.3109/0284186x.2015.1028590] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
UNLABELLED Anatomical changes in the head-and-neck (H&N) region during the course of treatment can cause deteriorated dose distributions. Different replanning strategies were investigated for volumetric modulated arc therapy (VMAT) and intensity-modulated proton therapy (IMPT). MATERIAL AND METHODS For six H&N patients two repeated computed tomography (CT) and magnetic resonance (MR) (CT1/MR1 at week 2 and CT2/MR2 at week 4) scans were acquired additionally to the initial planning CT/MR. Organs-at-risk (OARs) and three targets (CTV70Gy, CTV63Gy, CTV56Gy) were delineated on MRs and transferred to respective CT data set. Simultaneously integrated boost plans were created using VMAT (two arcs) and IMPT (four beams). To assess the need of replanning the initial VMAT and IMPT plans were recalculated on repeated CTs. Furthermore, VMAT and IMPT plans were replanned on the repeated CTs. A Demon algorithm was used for deformable registration of the repeated CTs with the initial CT and utilized for dose accumulation. Total dose estimations were performed to compare ART versus standard treatment strategies. RESULTS Dosimetric evaluation of recalculated plans on CT1 and CT2 showed increasing OAR doses for both, VMAT and IMPT. The target coverage of recalculated VMAT plans was considered acceptable in three cases, while for all IMPT plans it dropped. Adaptation of the treatment reduced D2% for brainstem by 6.7 Gy for VMAT and by 8 Gy for IMPT, for particular patients. These D2% reductions were reaching 9 Gy and 14 Gy for the spinal cord. ART improved target dose homogeneity, especially for protons, i.e. D2% decreased by up to 8 Gy while D98% increased by 1.2 Gy. CONCLUSION ART showed benefits for both modalities. However, as IMPT is more conformal, the magnitude of dosimetric changes was more pronounced compared to VMAT. Large anatomic variations had a severe impact on treatment plan quality for both VMAT and IMPT. ART is justified in those cases irrespective of treatment modalities.
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Affiliation(s)
- Joanna Góra
- a Department of Radiation Oncology , Medical University of Vienna/AKH Wien , Vienna , Austria
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