Deformable image registration for defining the postimplant seroma in permanent breast seed implant brachytherapy

Hilts, Michelle; Batchelar, Deidre; Rose, Jim; Crook, Juanita

doi:10.1016/j.brachy.2014.11.003

Cited by 18 publications

(6 citation statements)

References 30 publications

(33 reference statements)

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“…Clinical outcomes published at a median follow-up of 63 months found a local recurrence rate of 1.2 ± 1.2%, comparable to nomogram-based estimates for whole breast irradiation [8]. As the PBSI technique matures, numerous studies in recent literature have investigated how to optimize aspects of the treatment process, including treatment planning [9,10,11,12], training [13,14], clinical practice [15,16], and post-implant analysis [17,18,19,20,21].…”

Section: Purposementioning

confidence: 77%

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Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Watt¹,

Skarsgard²,

Roumeliotis³

et al. 2019

jcb

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PurposePost-implant analysis in permanent breast seed implant (PBSI) brachytherapy is an important component of the quality assurance process that indicates dosimetric quality relevant to patient outcome, indicating salvage therapy if inadequate, as well as providing feedback to the brachytherapy team to improve future treatments. To measure geometric indices on implant quality, plan reconstruction must be performed to correlate each planned and post-implant seed location. In this work, a simulated-annealing-based algorithm is developed to perform this plan reconstruction automatically.Material and methodsThe plan reconstruction algorithm was developed in MATLAB, taking the patient pre-treatment and post-implant (Day 0) plan and associated contours as inputs. For 19 treated patients, a reconstruction was obtained that defined the correspondence between each planned and post-implant seed. The simulated-annealing algorithm was used to reconstruct each patient 10 times to assess the variability in convergence. Manual reconstructions performed by at least two independent observers to obtain consensus were defined as the ground truth; these were compared to the automatic reconstructions obtained by the algorithm. Metrics on seed placement accuracy and needle strand angulation were calculated for the patients.ResultsThe algorithm performed reconstructions on 19 patients (1235 seeds) with ground-truth reconstructions, obtaining 97 ± 8% correct matches. This strong performance indicates the ability to incorporate this algorithm into the clinical quality assurance workflow.ConclusionsThe plan reconstruction algorithm developed herein performed very well in a 19-patient cohort. This algorithm can be incorporated into the clinical process to assist in the assessment of center-specific seed placement accuracy and can be used to gather implant metrics in an automated, standardized fashion for future PBSI trials.

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Section: Purposementioning

confidence: 77%

“…A post-plan was completed on all patients using a similar process to that described by Hilts et al . [17]. Briefly, the post-implant CT scan was deformably registered to the planning CT scan to obtain the CTV contour, which was then reviewed and adjusted as necessary by a radiation oncologist.…”

Section: Methodsmentioning

confidence: 99%

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Watt¹,

Skarsgard²,

Roumeliotis³

et al. 2019

jcb

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“…A 2 mm skin layer was contoured to calculate the maximum dose to a skin volume of 0.2 cc as a surrogate measure of maximum dose to a 1 cm 2 area (Hilts et al 2015). Additionally, a 2 mm skin contour limited to the PTV skin projection as used during the implantation was created.…”

Section: Brachytherapymentioning

confidence: 99%

Radiochromic film in vivo dosimetry predicts early the risk of acute skin toxicity for brachytherapy partial breast irradiation

et al. 2020

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Brachytherapy accelerated partial breast irradiation (APBI) is well tolerated, but reported acute toxicities including moist desquamation rates range from 7% to 39%. Moist desquamation is correlated to long-term skin toxicity and high skin dose is the main risk factor. This study uses radiochromic films for in vivo skin dosimetry of low dose rate (LDR) APBI brachytherapy and prediction of skin toxicity. Patients participating in a clinical trial assessing skin toxicity of LDR seed brachytherapy were included in this study. Following the seed implantation procedure, patients were asked to wear a customized oval shaped radiochromic film on the skin projection of the planned target volume (PTV) for 24 h. Exposed films were collected, and maximum point doses were measured. In addition, maximum doses to a small skin volume (D0.2cc) were calculated on the pre- and post-implant CT-scan. Acute skin toxicities (redness, pigmentation, induration and dermatitis) were scored by the treating physician for 2 months during follow-up visits. Skin dose measurements and acute toxicity were available for 18 consecutive patients. The post-implant calculated maximum skin doses (D0.2cc), 60.8 Gy (SD ± 41.0), were on average 30% higher than those measured in vivo (Dmax-film), 46.6 Gy (SD ± 19.3), but those values were highly significantly correlated (Spearman’s rho 0.827, p < 0.001). Also, dermatitis and induration were significantly correlated with higher in vivo measured and post-implant calculated skin dose. Pre-implant dosimetry was not correlated with measured or post-implant skin dose or side effects. Radiochromic films can reliably diagnose excess dose to the skin during the first 24 h and predict skin toxicity, which enables preventative measures. Trial registration: Nederlands Trial Register (www.trialregister.nl), NTR6549, the trial was registered prospectively on 27 June 2017. ABR number: NL56210.078.16

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“…So far, several commercial registration software, such as Velocity, 15 MIM, 21 and Mirada, 10 have been employed by researchers. The performances of these software in contour propagation have been fully investigated 22 .…”

Section: Introductionmentioning

confidence: 99%

The application of multiple metrics in deformable image registration for target volume delineation of breast tumor bed

Xie

Song

et al. 2022

J Applied Clin Med Phys

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Background and purpose For postoperative breast cancer patients, deformable image registration (DIR) is challenged due to the large deformations and non‐correspondence caused by tumor resection and clip insertion. To deal with it, three metrics (fiducial‐, region‐, and intensity‐based) were jointly used in DIR algorithm for improved accuracy. Materials and methods Three types of metrics were combined to form a single‐objective function in DIR algorithm. Fiducial‐based metric was used to minimize the distance between the corresponding point sets of two images. Region‐based metric was used to improve the overlap between the corresponding areas of two images. Intensity‐based metric was used to maximize the correlation between the corresponding voxel intensities of two images. The two CT images, one before surgery and the other after surgery, were acquired from the same patient in the same radiotherapy treatment position. Twenty patients who underwent breast‐conserving surgery and postoperative radiotherapy were enrolled in this study. Results For target registration error, the difference between the proposed and the conventional registration methods was statistically significant for soft tissue (2.06 vs. 7.82, p = 0.00024 < 0.05) and body boundary (3.70 vs. 6.93, p = 0.021 < 0.05). For visual assessment, the proposed method achieved better matching result for soft tissue and body boundary. Conclusions Comparing to the conventional method, the registration accuracy of the proposed method was significantly improved. This method provided a feasible way for target volume delineation of tumor bed in postoperative radiotherapy of breast cancer patients.

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Deformable image registration for defining the postimplant seroma in permanent breast seed implant brachytherapy

Cited by 18 publications

References 30 publications

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Radiochromic film in vivo dosimetry predicts early the risk of acute skin toxicity for brachytherapy partial breast irradiation

The application of multiple metrics in deformable image registration for target volume delineation of breast tumor bed

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