Dose summation and image registration strategies for radiobiologically and anatomically corrected dose accumulation in pelvic re-irradiation

Abstract Introduction Deformable image registration (DIR) is used to modify structures according to anatomical changes for observing the dosimetric effect. In this study, megavoltage computed tomography (MVCT) images were used to generate cumulative doses for nasopharyngeal cancer (NPC) patients by various DIR methods. The performance of the multiple DIR methods was analysed, and the impact of dose accumulation was assessed. Patients and methods The study consisted of five NPC patients treated with a helical tomotherapy unit. The weekly MVCT images at the 1st, 6th, 11th, 16th, 21st, 26th, and 31st fractions were used to assess the dose accumulation by the four DIR methods. The cumulative dose deviations from the initial treatment plan were analysed, and correlations of these variations with the anatomic changes and DIR methods were explored. Results The target dose received a slightly different result from the initial plan at the end of the treatment. The organ dose differences increased as the treatment progressed to 6.8% (range: 2.2 to 10.9%), 15.2% (range: -1.7 to 36.3%), and 6.4% (range: -1.6 to 13.2%) for the right parotid, the left parotid, and the spinal cord, respectively. The mean uncertainty values to estimate the accumulated doses for all the DIR methods were 0.21 ± 0.11 Gy (target dose), 1.99 ± 0.76 Gy (right parotid), 1.19 ± 0.24 Gy (left parotid), and 0.41 ± 0.04 Gy (spinal cord). Conclusions Accuracy of the DIR methods affects the estimation of dose accumulation on both the target dose and the organ dose. The DIR methods provide an adequate dose estimation technique for observation as a result of inter-fractional anatomic changes and are beneficial for adaptive treatment strategies.

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The impact of robustness of deformable image registration on contour propagation and dose accumulation for head and neck adaptive radiotherapy

Journal of Applied Clinical Medical Physics ◽

10.1002/acm2.12361 ◽

2018 ◽

Vol 19 (4) ◽

pp. 185-194 ◽

Cited By ~ 8

Author(s):

Lian Zhang ◽

Zhi Wang ◽

Chengyu Shi ◽

Tengfei Long ◽

X. George Xu

Keyword(s):

Image Registration ◽

Head And Neck ◽

Deformable Image Registration ◽

Adaptive Radiotherapy ◽

Dose Accumulation ◽

Contour Propagation ◽

The Impact

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PO-1535 Deformable image registration uncertainty for dose accumulation of proton therapy for H&N tumors

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)07986-x ◽

2021 ◽

Vol 161 ◽

pp. S1259-S1261

Author(s):

F. Amstutz ◽

P.G. D’Almeida ◽

F. Albertini ◽

L. Nenoff ◽

D.C. Weber ◽

...

Keyword(s):

Image Registration ◽

Proton Therapy ◽

Deformable Image Registration ◽

Dose Accumulation

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Dose accumulation with deformable image registration method using helical tomotherapy images for prostate cancer

Journal of Radiotherapy in Practice ◽

10.1017/s1460396919000256 ◽

2019 ◽

Vol 19 (1) ◽

pp. 25-29

Author(s):

Warit Thongsuk ◽

Imjai Chitapanarux ◽

Somsak Wanwilairat ◽

Wannapha Nobnop

Keyword(s):

Prostate Cancer ◽

Computed Tomography ◽

Image Registration ◽

Cancer Patients ◽

Helical Tomotherapy ◽

Deformable Image Registration ◽

High Dose ◽

Registration Method ◽

Dose Accumulation ◽

Dose Volume

AbstractPurpose:To evaluate changes of accumulated doses from an initial plan in each fraction by deformable image registration (DIR) with daily megavoltage computed tomography (MVCT) images from helical tomotherapy for prostate cancer patients.Materials and methods:The MVCT images of five prostate cancer patients were acquired by using a helical tomotherapy unit before the daily treatment fraction began. All images data were exported to DIR procedures by MIM software, in which the planned kilovoltage computed tomography (kVCT) images were acting as the source images with the daily MVCT acquired as the target images for registration. The automatic deformed structure was used to access the volume variation and daily dose accumulation to each structure. All dose-volume parameters were compared to the initial planned dose.Results:The actual median doses of the planning target volume (PTV) received 70 Gy and 50.4 Gy were decreased at the end of the treatment with an average 1·0 ± 0·67% and 2·1 ± 1·54%, respectively. As regards organs at risk (OARs), the bladder and rectum dose-volume parameters tended to increase from the initial plan. The high-dose regions of the bladder and rectum, however, were decreased from the initial plan at the end of the treatment.Conclusions:The daily actual dose differs from the initial planned dose. The accumulated dose of target tends to be lower than the initial plan, but tends to be higher than the initial plan for the OARs. Therefore, inter-fractional anatomic changes should be considered by the DIR methods, which would be useful as clinically informative and beneficial for adaptive treatment strategies.

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A novel concept to include uncertainties in the evaluation of stereotactic body radiation therapy after 4D dose accumulation using deformable image registration

Medical Physics ◽

10.1002/mp.13759 ◽

2019 ◽

Vol 46 (10) ◽

pp. 4346-4355

Author(s):

Juan Diego Azcona ◽

Carlos Huesa‐Berral ◽

Marta Moreno‐Jiménez ◽

Benigno Barbés ◽

José Javier Aristu ◽

...

Keyword(s):

Radiation Therapy ◽

Image Registration ◽

Stereotactic Body Radiation Therapy ◽

Deformable Image Registration ◽

Stereotactic Body Radiation ◽

Dose Accumulation ◽

Novel Concept

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RE-irradiation (RE-RT) of head and neck cancer (HNC): Dose accumulation using deformable image registration (DIR) and comparison with rigid registration (RIR)

Physica Medica ◽

10.1016/j.ejmp.2016.01.028 ◽

2016 ◽

Vol 32 ◽

pp. 7-8

Author(s):

E. Cagni ◽

A. Botti ◽

R. Micera ◽

L. Orsingher ◽

M. Orlandi ◽

...

Keyword(s):

Head And Neck Cancer ◽

Image Registration ◽

Head And Neck ◽

Neck Cancer ◽

Deformable Image Registration ◽

Rigid Registration ◽

Dose Accumulation

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Impact of deformable image registration on dose accumulation applied electrocardiograph-gated 4DCT in the heart and left ventricular myocardium during esophageal cancer radiotherapy

Radiation Oncology ◽

10.1186/s13014-018-1093-z ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Ying Tong ◽

Yong Yin ◽

Pinjing Cheng ◽

Guanzhong Gong

Keyword(s):

Esophageal Cancer ◽

Image Registration ◽

Deformable Image Registration ◽

Ventricular Myocardium ◽

Left Ventricular ◽

Left Ventricular Myocardium ◽

Cancer Radiotherapy ◽

Dose Accumulation

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Evaluation of rectum and bladder dose accumulation from external beam radiotherapy and brachytherapy for cervical cancer using two different deformable image registration techniques

Journal of Radiation Research ◽

10.1093/jrr/rrx028 ◽

2017 ◽

Vol 58 (5) ◽

pp. 720-728 ◽

Cited By ~ 7

Author(s):

Noriyuki Kadoya ◽

YuYa Miyasaka ◽

Takaya Yamamoto ◽

Yoshihiro Kuroda ◽

Kengo Ito ◽

...

Keyword(s):

Cervical Cancer ◽

Image Registration ◽

External Beam Radiotherapy ◽

Deformable Image Registration ◽

Dose Effect ◽

Reference Image ◽

External Beam ◽

Similarity Coefficients ◽

Ground Truth Data ◽

Dose Accumulation

ABSTRACT We evaluated dose–volume histogram (DVH) parameters based on deformable image registration (DIR) between brachytherapy (BT) and external beam radiotherapy (EBRT) that included a center-shielded (CS) plan. Eleven cervical cancer patients were treated with BT, and their pelvic and CS EBRT were studied. Planning CT images for EBRT and BT (except for the first BT, used as the reference image) were deformed with DIR to reference image. We used two DIR parameter settings: intensity-based and hybrid. Mean Dice similarity coefficients (DSCs) comparing EBRT with the reference for the uterus, rectum and bladder were 0.81, 0.77 and 0.83, respectively, for hybrid DIR and 0.47, 0.37 and 0.42, respectively, for intensity-based DIR (P < 0.05). D1 cm3 for hybrid DIR, intensity-based DIR and DVH addition were 75.1, 81.2 and 78.2 Gy, respectively, for the rectum, whereas they were 93.5, 92.3 and 94.3 Gy, respectively, for the bladder. D2 cm3 for hybrid DIR, intensity-based DIR and DVH addition were 70.1, 74.0 and 71.4 Gy, respectively, for the rectum, whereas they were 85.4, 82.8 and 85.4 Gy, respectively, for the bladder. Overall, hybrid DIR obtained higher DSCs than intensity-based DIR, and there were moderate differences in DVH parameters between the two DIR methods, although the results varied among patients. DIR is only experimental, and extra care should be taken when comparing DIR-based dose values with dose–effect curves established using DVH addition. Also, a true evaluation of DIR-based dose accumulation would require ground truth data (e.g. measurement with physical phantom).

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