Comparison of 12 deformable registration strategies in adaptive radiation therapy for the treatment of head and neck tumors
Comparison of 12 deformable registration strategies in adaptive radiation therapy for the treatment of head and neck tumors
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DOI：
10.1016/j.radonc.2008.04.010
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发表时间：
2008-10-01
影响因子：
5.7
通讯作者：
Gregoire, Vincent
中科院分区：
文献类型：
--
作者：
Castadot, Pierre;Lee, John Aldo;Gregoire, Vincent
背景和目的：在头颈部（HN）放射治疗（RT）或化学放射治疗期间，体重减轻、肿瘤收缩和组织水肿引起患者解剖结构的实质性改变。这些修改可能会影响靶体积（TV）和危及器官（OAR）的剂量分布。自适应放射治疗（ART）是一种可能的策略，可以改善治疗效果，其中患者在治疗期间多次重新成像和重新计划。然而，它需要使用特定的可变形配准（DR）算法，需要对临床材料进行适当的验证。材料和方法：12个体素为基础的DR策略进行了比较，5例患者的数据集与计算机断层扫描（CT）成像之前，一次在RT（平均剂量为36.8戈伊后的平均值）：水平集（LS），以多分辨率实现的水平集（LSMR），以多分辨率实现的Demons算法（D-MR），D-MR后接LS（D-MR-LS），通过变分法（F3 CV）和F3 CV后接LS（F3 CV-LS）的快速自由变形配准。还测试了被称为“局部M平滑器”的边缘保留去噪滤波器的使用，该滤波器被应用于配准的图像并与所有上述策略组合（fLS、fLS（MR）、fD（MR）、fD（MR）-LS、fF 3CV、fF 3CV-LS）。将所有这些策略与基于互信息（MI，fMI）的刚性配准进行比较。还研究了按时间顺序和反时间顺序的登记。使用基于容量的标准对各种DR策略进行了评估（即骰子相似性指数，DSI）和体素强度标准（即相关系数CC）。结果：在DSI分析中，最佳的三种策略是D-MR、fD（MR）-LS和fD（MR），中位数分别为0.86、0.85和0.85;相应的四分位距（IQR）分别为9.6%、10%和10.2%。对于CC分析，最佳的三种策略是fD（MR）-LS、D-MR-LS和D-MR，中位数分别为0.97、0.96和0.94;相应的IQR分别达到11%、9%和15%。关于时间序列分析，逆时间配准（所有可变形策略合并）显示出更好的中位DSI值（0.84 vs 0.83，p < 0.001）和IQR（11.2% vs 12.4%）。对于CC，反时序配准（所有可变形策略合并）的中位数略低（0.91 vs 0.912，p < 0.001），但IQR更好（16.4% vs 21%）。结论：使用fD（MR）-LS是HN-ART的良好配准策略，因为它是DSI和CC的中位数和IQR的最佳折衷。尽管在CC方面不太稳健，但D-MR是一个很好的替代方案。没有一个时间顺序看起来是上级的。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学89（2008）1-12。
Background and purpose: Weight loss, tumor shrinkage, and tissue edema induce substantial modification of patient's anatomy during head and neck (HN) radiotherapy (RT) or chemo-radiotherapy. These modifications may impact on the dose distribution to both target volumes (TVs) and organs at risk (OARs). Adaptive radiotherapy (ART) where patients are re-imaged and re-planned several times during the treatment is a possible strategy to improve treatment delivery. It however requires the use of specific deformable registration (DR) algorithms that requires proper validation on a clinical material.Materials and methods: Twelve voxel-based DR strategies were compared with a dataset of 5 patients imaged with computed tomography (CT) before and once during RT (on average after a mean dose of 36.8 Gy): level-set (LS), level-set implemented in multi-resolution (LSMR), Demons' algorithm implemented in multi-resolution (D-MR), D-MR followed by LS (D-MR-LS), fast free-form deformable registration via calculus of variations (F3CV) and F3CV followed by LS (F3CV-LS). The use of an edge-preserving denoising filter called "local M-smoothers" applied to the registered images and combined to all the aforesaid strategies was also tested (fLS, fLS(MR), fD(MR), fD(MR)-LS, fF3CV, fF3CV-LS). All these strategies were compared to a rigid registration based on mutual information (MI, fMI). Chronological and anti-chronological registrations were also studied. The various DR strategies were evaluated using a volume-based criterion (i.e. Dice similarity index, DSI) and a voxel-intensity criterion (i.e. correlation coefficient, CC) on a total of 18 different manually contoured volumes.Results: For the DSI analysis, the best three strategies were D-MR, fD(MR)-LS, and fD(MR), with the median values of 0.86, 0.85 and 0.85, respectively; corresponding inter-quartile range (IQR) reached 9.6%, 10% and 10.2%. For the CC analysis, the best three strategies were fD(MR)-LS, D-MR-LS and D-MR with the median values of 0.97, 0.96 and 0.94, respectively; corresponding IQR reached 11%; 9% and 15%. Concerning the time-sequence analysis, the anti-chronological registration (all deformable strategies pooled) showed a better median DSI value (0.84 vs 0.83, p < 0.001) and IQR (11.2% vs 12.4%). For CC, the anti-chronological registration (all deformable strategies pooled) had a slightly lower median value (0.91 vs 0.912, p < 0.001) but a better IQR (16.4% vs 21%).Conclusions: The use of fD(MR)-LS is a good registration strategy for HN-ART as it is the best compromise in terms of median and IQR for both DSI and CC. Even though less robust in terms of CC, D-MR is a good alternative. None of the time-sequence appears superior. (C) 2008 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 89 (2008) 1-12.