A multi-institution evaluation of deformable image registration algorithms for automatic organ delineation in adaptive head and neck radiotherapy.
A multi-institution evaluation of deformable image registration algorithms for automatic organ delineation in adaptive head and neck radiotherapy.
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DOI：
10.1186/1748-717x-7-90
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发表时间：
2012-06-15
期刊：
影响因子：
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通讯作者：
Bzdusek K
中科院分区：
文献类型：
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作者：
Hardcastle N;Tomé WA;Cannon DM;Brouwer CL;Wittendorp PW;Dogan N;Guckenberger M;Allaire S;Mallya Y;Kumar P;Oechsner M;Richter A;Song S;Myers M;Polat B;Bzdusek K
适应性放疗旨在识别放射治疗过程中的解剖偏差，并修改治疗计划以保持治疗目标。这就需要使用最新的成像数据来定义感兴趣区域（roi）。本研究探讨了使用可变形图像配准（DIR）自动传播roi的临床应用。22例患者的目标（GTV）和器官危险（OAR） roi从计划CT扫描到治疗前CT扫描的非刚性传播。传播roi与专家医生绘制的治疗前扫描roi进行定量比较，使用Dice分数和平均切片Hausdorff距离，以及gtv的质心距离。传播的roi由专家进行定性检查，并根据其临床效用进行评分。基于所使用的度量，可以观察到dir传播的roi和专家绘制的roi之间的良好一致性。使用DIR生成的所有roi中有94%被评为临床有用，需要很少或不需要编辑。然而，27%（12/44）的gtv需要进行重大编辑。我们成功地在22例患者身上使用DIR来繁殖靶和桨结构，桨结构的解剖结构很好地吻合。建议由主治医生彻底检查扩散的靶结构。
Adaptive Radiotherapy aims to identify anatomical deviations during a radiotherapy course and modify the treatment plan to maintain treatment objectives. This requires regions of interest (ROIs) to be defined using the most recent imaging data. This study investigates the clinical utility of using deformable image registration (DIR) to automatically propagate ROIs. Target (GTV) and organ-at-risk (OAR) ROIs were non-rigidly propagated from a planning CT scan to a per-treatment CT scan for 22 patients. Propagated ROIs were quantitatively compared with expert physician-drawn ROIs on the per-treatment scan using Dice scores and mean slicewise Hausdorff distances, and center of mass distances for GTVs. The propagated ROIs were qualitatively examined by experts and scored based on their clinical utility. Good agreement between the DIR-propagated ROIs and expert-drawn ROIs was observed based on the metrics used. 94% of all ROIs generated using DIR were scored as being clinically useful, requiring minimal or no edits. However, 27% (12/44) of the GTVs required major edits. DIR was successfully used on 22 patients to propagate target and OAR structures for ART with good anatomical agreement for OARs. It is recommended that propagated target structures be thoroughly reviewed by the treating physician.