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Ward J, Gill S, Armstrong K, Fogarty T, Tan D, Scott A, Yahya A, Dhaliwal SS, Jacques A, Tang C. Randomised controlled trial on the effect of simethicone bowel preparation on rectal variability during image-guided radiation therapy for prostate cancer (SPoRT study). J Med Imaging Radiat Oncol 2022; 66:866-873. [PMID: 35322563 DOI: 10.1111/1754-9485.13404] [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: 08/26/2021] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this study was to assess whether simethicone reduces the rectal volume (RV) and gas volume (GV), to increase treatment accuracy and to decrease toxicity of prostate radiation therapy. METHODS 30 patients were randomised to simethicone or no intervention. Cone-beam computed tomography (CBCT) scans were performed on Days 1-3 and weekly until completion of radiation. RV and GV were measured using volume delineation. Toxicity data were collected. RESULTS 264 CBCTs were analysed. RV and GV were not significantly different in the simethicone group compared with the control group at each time point (P >0.05) after adjusting for Week 0 values as a covariate. The simethicone group showed an average reduction in RV and GV of 10% and 21%, respectively, compared with the control group (P >0.05). Standard deviations were calculated over 10 time points, which were grouped to represent the first 2-3 weeks of radiation therapy versus subsequent weeks. These were not significantly different between the simethicone and control group. However, there was a statistically significant decrease in the variability of RV at time points 6-10 compared with time points 1-5 within the simethicone group (P = 0.012), but no significant difference was found between these grouped time points in the control group (P = 0.581). The toxicity questionnaires showed no significant difference between the groups. CONCLUSIONS Simethicone did not decrease the RV or GV overall. However, simethicone appeared to significantly decrease the RV variability from Week three onwards. This suggests that taking simethicone two to three weeks before starting radiation therapy may reduce RV variability, although a larger study is needed to confirm this.
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Affiliation(s)
- Jennifer Ward
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Suki Gill
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,Division of Internal Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Kevin Armstrong
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Tamara Fogarty
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Daren Tan
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia
| | - Alison Scott
- Radiation Oncology Medical Physics, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia
| | - Aylin Yahya
- Department of Radiation Oncology, Clinical Trials and Research Unit, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia
| | - Satvinder Singh Dhaliwal
- Department of Radiation Oncology, Clinical Trials and Research Unit, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.,Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.,Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, George Town, Pulau Pinang, Malaysia
| | - Angela Jacques
- Department of Research, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Colin Tang
- Department of Radiation Oncology, Sir Charles Gairdner Hospital Cancer Centre, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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Knybel L, Cvek J, Blazek T, Binarova A, Parackova T, Resova K. Prostate deformation during hypofractionated radiotherapy: an analysis of implanted fiducial marker displacement. Radiat Oncol 2021; 16:235. [PMID: 34876173 PMCID: PMC8650520 DOI: 10.1186/s13014-021-01958-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report prostate deformation during treatment, based on an analysis of fiducial marker positional differences in a large sample. MATERIAL AND METHODS This study included 144 patients treated with prostate stereotactic body radiation therapy after implantation in each of 4 gold fiducial markers (FMs), which were located and numbered consistently. The center of mass of the FMs was recorded for every pair of X-ray images taken during treatment. The distance between each pair of fiducials in the live X-ray images is calculated and compared with the respective distances as determined in the CT volume. The RBE is the difference between these distances. Mean RBE and intrafraction and interfraction RBE were evaluated. The intrafraction and intefraction RBE variability were defined as the standard deviation, respectively, of all RBE during 1 treatment fraction and of the mean daily RBE over the whole treatment course. RESULTS We analyzed 720 treatment fractions comprising 24,453 orthogonal X-ray image acquisitions. We observed a trend to higher RBE related to FM4 (apex) during treatment. The fiducial marker in the prostate apex could not be used in 16% of observations, in which RBE was > 2.5 mm. The mean RBEavg was 0.93 ± 0.39 mm (range 0.32-1.79 mm) over the 5 fractions. The RBEavg was significantly lower for the first and second fraction compared with the others (P < .001). The interfraction variability of RBEavg was 0.26 ± 0.16 mm (range 0.04-0.74 mm). The mean intrafraction variability of all FMs was 0.45 ± 0.25 mm. The highest Pearson correlation coefficient was observed between FM2 and FM3 (middle left and right prostate) (R = 0.78; P < .001). Every combination with FM4 yielded lower coefficients (range 0.66-0.71; P < .001), indicating different deformation of the prostate apex. CONCLUSIONS Ideally, prostate deformation is generally small, but it is very sensitive to rectal and bladder filling. We observed RBE up to 11.3 mm. The overall correlation between FMs was affected by shifts of individual fiducials, indicating that the prostate is not a "rigid" organ. Systematic change of RBE average between subsequent fractions indicates a systematic change in prostate shape.
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Affiliation(s)
- Lukas Knybel
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Jakub Cvek
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic.
| | - Tomas Blazek
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Andrea Binarova
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Tereza Parackova
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
| | - Kamila Resova
- Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
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Gao Y, Zhao B, Gao X, Qi X, Liu S, Li Y, Jia C. Quantifying intra-fractional prostate motion trajectory for establishing a new gating strategy: a preliminary study. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2020. [DOI: 10.1080/16878507.2020.1785113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Yan Gao
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - Bo Zhao
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle & Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
| | - Xianshu Gao
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - Xin Qi
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - Siwei Liu
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - Yue Li
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
| | - Chenghao Jia
- Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, China
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Singhrao K, Ruan D, Fu J, Gao Y, Chee G, Yang Y, King C, Hu P, Kishan AU, Lewis JH. Quantification of fiducial marker visibility for MRI-only prostate radiotherapy simulation. Phys Med Biol 2020; 65:035015. [PMID: 31881546 DOI: 10.1088/1361-6560/ab65db] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
To objectively compare the suitability of MRI pulse sequences and commercially available fiducial markers (FMs) for MRI-only prostate radiotherapy simulation. Most FMs appear as small signal voids in MRI images making them difficult to differentiate from tissue heterogeneities such as calcifications. In this study we use quantitative metrics to objectively evaluate the visibility of FMs in 27 patients and an anthropomorphic phantom with a variety of standard clinical MRI pulse sequences and commercially available FMs. FM visibility was quantified using the local contrast-to-noise-ratio (lCNR), the difference between the 80th and 20th percentile iso-intensity FM volumes (V fall) and the largest iso-intensity volume that can be distinguished from background: apparent-marker-volume (AMV). A larger lCNR and AMV, and smaller V fall represents a more easily identifiable FM. The number of non-marker objects visualized by each pulse sequence was calculated using FM-derived template-matching. The FM-based target-registration-error (TRE) between each MRI and the planning-CT image was calculated. Fiducial marker visibility was rated by two medical physicists with over three years of experience examining MRI-only prostate simulation images. The rater's classification accuracy was quantified using the F 1 score, which is the harmonic mean of the rater's precision and recall. These quantitative metrics and human observer ratings were used to evaluate FM identifiability in images from nine subtypes of T 1-weighted, T 2-weighted and gradient echo (GRE) pulse sequences in a 27-patient study. A phantom study was conducted to quantify the visibility of 8 commercially available FMs. In the patient study, the largest mean lCNR and AMV and, smallest normalized V fall were produced by the 3.0 T multiple-echo GRE pulse sequence (T 1-VIBE, 2° flip angle, 1.23 ms and 2.45 ms echo-times). This pulse sequence produced no false marker detections and TREs less than 2 mm in the left-right, anterior-posterior and cranial-caudal directions, respectively. Human observers rated the 1.23 ms echo-time GRE images with the best average marker visibility score of 100% and an F 1 score of 1. In the phantom study, the Gold-Anchor GA-200X-20-B (deployed in a folded configuration) produced the largest sequence averaged lCNR and AMV measurements at 16.1 and 16.7 mm3, respectively. Using quantitative visibility and distinguishability metrics and human observer ratings, the patient study demonstrated that multiple-echo GRE images produced the best gold FM visibility and distinguishability. The phantom study demonstrated that markers manufactured from platinum or iron-doped gold quantitatively produced superior visibility compared to their pure gold counterparts.
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Affiliation(s)
- Kamal Singhrao
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA 90095, United States of America
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Snoj Z, Gill AB, Rundo L, Sushentsev N, Barrett T. Three-dimensional MRI evaluation of the effect of bladder volume on prostate translocation and distortion. Radiol Oncol 2020; 54:48-56. [PMID: 31940289 PMCID: PMC7087418 DOI: 10.2478/raon-2020-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022] Open
Abstract
Background The accuracy of any radiation therapy delivery is limited by target organ translocation and distortion. Bladder filling is one of the recognised factors affecting prostate translocation and distortion. The purpose of our study was to evaluate the effect of bladder volume on prostate translocation and distortion by using detailed three-dimensional prostate delineation on MRI. Patients and methods Fifteen healthy male volunteers were recruited in this prospective, institutional review board-approved study. Each volunteer underwent 4 different drinking preparations prior to imaging, with MR images acquired pre- and post-void. MR images were co-registered by using bony landmarks and three-dimensional contouring was performed in order to assess the degree of prostate translocation and distortion. According to changes in bladder or rectum distention, subdivisions were made into bladder and rectal groups. Studies with concomitant change in both bladder and rectal volume were excluded. Results Forty studies were included in the bladder volume study group and 8 in the rectal volume study group. The differences in rectal volumes yielded higher levels of translocation (p < 0.01) and distortion (p = 0.02) than differences in bladder volume. Moderate correlation of prostate translocation with bladder filling was shown (r = 0.64, p < 0.01). There was no important prostate translocation when bladder volume change was < 2-fold (p < 0.01). Moderate correlation of prostate distortion with bladder filling was shown (r = 0.61, p < 0.01). Conclusions Bladder volume has a minimal effect on prostate translocation and effect on prostate distortion is negligible. Prostate translocation may be minimalised if there is < 2-fold increase in the bladder volume.
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Affiliation(s)
- Ziga Snoj
- Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
- Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Andrew B. Gill
- Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
- Department of Medical Physics, Cambridge University Hospitals, Cambridge, UK
| | - Leonardo Rundo
- Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Nikita Sushentsev
- Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
- CamPARI Clinic, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK
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Motegi K, Tachibana H, Motegi A, Hotta K, Baba H, Akimoto T. Usefulness of hybrid deformable image registration algorithms in prostate radiation therapy. J Appl Clin Med Phys 2018; 20:229-236. [PMID: 30592137 PMCID: PMC6333149 DOI: 10.1002/acm2.12515] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 11/04/2018] [Accepted: 11/27/2018] [Indexed: 11/11/2022] Open
Abstract
To evaluate the accuracy of commercially available hybrid deformable image registration (DIR) algorithms when using planning CT (pCT) and daily cone-beam computed tomography (CBCT) in radiation therapy for prostate cancer. The hybrid DIR algorithms in RayStation and MIM Maestro were evaluated. Contours of the prostate, bladder, rectum, and seminal vesicles (SVs) were used as region-of-interest (ROIs) to guide image deformation in the hybrid DIR and to compare the DIR accuracy. To evaluate robustness of the hybrid DIR for prostate cancer patients with organs with volume that vary on a daily basis, such as the bladder and rectum, the DIR algorithms were performed on ten pairs of CT volumes from ten patients who underwent prostate intensity-modulated radiation therapy or volumetric modulated arc therapy. In a visual evaluation, MIM caused unrealistic image deformation in soft tissues, organs, and pelvic bones. The mean dice similarity coefficient (DSC) ranged from 0.46 to 0.90 for the prostate, bladder, rectum, and SVs; the SVs had the lowest DSC. Target registration error (TRE) at the centroid of the ROIs was about 2 mm for the prostate and bladder, and about 6 mm for the rectum and SVs. RayStation did not cause unrealistic image deformation, and could maintain the shape of pelvic bones in most cases. The mean DSC and TRE at the centroid of the ROIs were about 0.9 and within 5 mm generally. In both software programs, the use of ROIs to guide image deformation had the possibility to reduce any unrealistic image deformation and might be effective to keep the DIR physically reasonable. The pCT/CBCT DIR for the prostate cancer did not reduce the DIR accuracy because of the use of ROIs to guide the image deformation.
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Affiliation(s)
- Kana Motegi
- Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital East, Kashiwa-shi, Japan.,Particle Therapy Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa-shi, Japan
| | - Hidenobu Tachibana
- Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital East, Kashiwa-shi, Japan.,Particle Therapy Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa-shi, Japan
| | - Atsushi Motegi
- Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa-shi, Japan
| | - Kenji Hotta
- Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital East, Kashiwa-shi, Japan.,Particle Therapy Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa-shi, Japan
| | - Hiromi Baba
- Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital East, Kashiwa-shi, Japan.,Particle Therapy Division, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa-shi, Japan
| | - Tetsuo Akimoto
- Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa-shi, Japan
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Lee SL, Lee J, Craig T, Berlin A, Chung P, Ménard C, Foltz WD. Changes in apparent diffusion coefficient radiomics features during dose-painted radiotherapy and high dose rate brachytherapy for prostate cancer. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2018; 9:1-6. [PMID: 33458419 PMCID: PMC7807683 DOI: 10.1016/j.phro.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 01/22/2023]
Abstract
Background and purpose Dose escalation has improved cancer outcomes for patients with localized prostate cancer. Targeting subprostatic tumor regions for dose intensification may further improve outcomes. Apparent Diffusion Coefficient (ADC) maps may enable early radiation response assessment and dose adaptation. This study was a proof-of-principle investigation of early changes in ADC radiomics features for patients undergoing radiotherapy with dose escalation to the gross tumor volume (GTV). Materials and methods Fifty-nine patients were enrolled on a prospective tumor dose-escalation trial. Multi-parametric MRI was performed at baseline and week six, corresponding to the time of peak ADC change. GTV and prostate contours were deformably registered between baseline and week six T2-weighted images, and applied to ADC maps, to account for diminished image contrast post-EBRT and possible differences in prostate gland volume, shape, and orientation. A total of 101 radiomics features were tested for significant change post-EBRT using two-tailed Student's t-test. All ADC features of the prostate and GTV volumes were correlated using Pearson's coefficient (p < 0.00008, based on Bonferroni correction). Results ADC feature extraction was insensitive to b = 0 s/mm2 exclusion, and to gradient non-linearity bias. GTV presented predominant changes in first-order features, particularly 10Percentile, and prostate volumes presented predominant changes in second-order features. Changes in both first and second-order features of GTV and prostate ROIs were strongly correlated. Conclusions Our data confirmed significant changes in numerous GTV and prostate features assessed from ADC and T2-weighted images during radiotherapy; all of which may be potential biomarkers of early radiation response.
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Affiliation(s)
- Sangjune Laurence Lee
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Jenny Lee
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Tim Craig
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Peter Chung
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Cynthia Ménard
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Centre de Recherche du Centre Hospitalier de l Université de Montréal (CRCHUM), Montréal, Canada
| | - Warren D Foltz
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
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Ciardo D, Jereczek-Fossa BA, Petralia G, Timon G, Zerini D, Cambria R, Rondi E, Cattani F, Bazani A, Ricotti R, Garioni M, Maestri D, Marvaso G, Romanelli P, Riboldi M, Baroni G, Orecchia R. Multimodal image registration for the identification of dominant intraprostatic lesion in high-precision radiotherapy treatments. Br J Radiol 2017; 90:20170021. [PMID: 28830203 DOI: 10.1259/bjr.20170021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE The integration of CT and multiparametric MRI (mpMRI) is a challenging task in high-precision radiotherapy for prostate cancer. A simple methodology for multimodal deformable image registration (DIR) of prostate cancer patients is presented. METHODS CT and mpMRI of 10 patients were considered. Organs at risk and prostate were contoured on both scans. The dominant intraprostatic lesion was additionally delineated on MRI. After a preliminary rigid image registration, the voxel intensity of all the segmented structures in both scans except the prostate was increased by a specific amount (a constant additional value, A), in order to enhance the contrast of the main organs influencing its position and shape. 70 couples of scans were obtained by varying A from 0 to 800 and they were subsequently non-rigidly registered. Quantities derived from image analysis and contour statistics were considered for the tuning of the best performing A. RESULTS A = 200 resulted the minimum enhancement value required to obtain statistically significant superior registration results. Mean centre of mass distance between corresponding structures decreases from 7.4 mm in rigid registration to 5.3 mm in DIR without enhancement (DIR-0) and to 2.7 mm in DIR with A = 200 (DIR-200). Mean contour distance was 2.5, 1.9 and 0.67 mm in rigid registration, DIR-0 and DIR-200, respectively. In DIR-200 mean contours overlap increases of +13 and +24% with respect to DIR-0 and rigid registration, respectively. CONCLUSION Contour propagation according to the vector field resulting from DIR-200 allows the delineation of dominant intraprostatic lesion on CT scan and its use for high-precision radiotherapy treatment planning. Advances in knowledge: We investigated the application of a B-spline, mutual information-based multimodal DIR coupled with a simple, patient-unspecific but efficient contrast enhancement procedure in the pelvic body area, thus obtaining a robust and accurate methodology to transfer the functional information deriving from mpMRI onto a planning CT reference volume.
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Affiliation(s)
- Delia Ciardo
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.,2 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Giuseppe Petralia
- 3 Division of Radiology, European Institute of Oncology, Milan, Italy
| | - Giorgia Timon
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Dario Zerini
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Raffaella Cambria
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Elena Rondi
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Federica Cattani
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Alessia Bazani
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Rosalinda Ricotti
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Maria Garioni
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Davide Maestri
- 4 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Giulia Marvaso
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Paola Romanelli
- 1 Division of Radiation Oncology, European Institute of Oncology, Milan, Italy
| | - Marco Riboldi
- 5 Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Guido Baroni
- 5 Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.,6 Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica (CNAO Foundation), Pave, Italy
| | - Roberto Orecchia
- 2 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,7 Department of Medical Imaging and Radiation Sciences, European Institute of Oncology, Milan, Italy
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