Dose–volume analysis of locoregional recurrences in head and neck IMRT, as determined by deformable registration: A prospective multi-institutional trial

Shakam, A.; Scrimger, Rufus; Liu, Derek; Mohamed, Mohamed; Parliament, Matthew; Field, G; El-Gayed, Ali; Cadman, Patrick; Jha, Naresh; Warkentin, Heather; Skarsgard, David; Zhu, Qiaohao; Ghosh, Sunita

doi:10.1016/j.radonc.2011.05.008

Cited by 29 publications

(26 citation statements)

References 35 publications

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“…Only few studies have validated the registration of DxCT-SimCT; two of which have addressed the registration of pre-therapy diagnostic PET/CT to SimCT (15, 16), while two other studies have examined the registration of SimCT to post-recurrence DxCT (17, 18). The validation methodologies for DIR assessment in those studies varied from calculating the root mean squared error from a set of observer’s marked anatomic landmarks (15) to overlap indices and center of mass comparison for sample ROIs (16–18).…”

Section: Discussionmentioning

confidence: 99%

Quality Assurance Assessment of Diagnostic and Radiation Therapy–Simulation CT Image Registration for Head and Neck Radiation Therapy: Anatomic Region of Interest–based Comparison of Rigid and Deformable Algorithms

Mohamed¹,

Ruangskul²,

Awan³

et al. 2015

Radiology

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Purpose To develop a quality assurance (QA) workflow using a robust, curated, manually-segmented anatomic ROI library as a benchmark for quantitative assessment of different image registration techniques used for head and neck radiation therapy-simulation CT (SimCT) to diagnostic CT (DxCT) co-registration. Materials and Methods SimCTs and DxCTs of twenty patients with head and neck squamous cell carcinoma treated with curative-intent intensity modulated radiotherapy (IMRT) between August 2011 and May 2012 were retrospectively retrieved under an institutional review board approval. 68 reference anatomic regions of interest (ROIs) in addition to gross tumor and nodal targets were then manually contoured on each scan. DxCT was registered to SimCT rigidly, and through 4 different deformable image registration (DIR) algorithms; Atlas-based, B-spline, demons, and optical flow. The resultant deformed ROIs were compared with manually contoured reference ROIs using similarity coefficient metrics (i.e. Dice similarity coefficient) and surface distance metrics (i.e. 95% maximum Hausdorff distance). Non-parametric Steel test with control was used to compare different DIR algorithms to rigid registration (RIR) with post hoc Wilcoxon rank test for stratified metric comparison. Results A total of 2720 anatomic and 50 tumor/nodal ROIs were delineated. All DIR algorithms showed improved performance over RIR for both anatomic and target ROIs conformance as shown for the majority of comparison metrics (Steel test, p-value <0.008 after Bonferroni correction). The performance of different algorithms varied substantially with stratification by specific anatomic structures/category, and SimCT image slice thickness. Conclusion Development of a formal ROI-based QA workflow for registration assessment revealed improved performance with DIR techniques over RIR. After QA, DIR implementation should be the standard for head and neck DxCT-SimCT allineation, especially for target delineation.

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Section: Discussionmentioning

confidence: 99%

Quality Assurance Assessment of Diagnostic and Radiation Therapy–Simulation CT Image Registration for Head and Neck Radiation Therapy: Anatomic Region of Interest–based Comparison of Rigid and Deformable Algorithms

Mohamed¹,

Ruangskul²,

Awan³

et al. 2015

Radiology

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“…Note that the recurrence volume (13.6 cm 3 ) extends significantly beyond GTV-PET (10.7 cm 3 ) and, hence, is assigned to a more peripheral volume using the 95% volume overlap method. CT-T treatment planning CT, GTV-PET the 18 The PO-R and nidus point of origin have to be transferred from CT-R to CT-T and, hence, rely on high quality image co-registration. No significant differences were observed between the three focal methods and no effect on reproducibility was shown for any focal method using rigid or deformable co-registration.…”

Section: Discussionmentioning

confidence: 99%

“…One approach has been to determine the site of recurrence origin directly on the treatment planning scan [9]. Other studies have transferred the delineated recurrence volume by coregistration or expert opinion to the treatment planning scan and ascribed the recurrence to the highest isodose level encompassing either 50% or 95% of the recurrence volume [6,13,17,18,19]. The volume overlap method has some inherent weaknesses, especially when the purpose is to analyze the relation of the recurrence to small regions, and we recently published a pilot study introducing the concept of a focal method in order to analyze the pattern of failure with a spatial resolution matching the achievable dose modulation in dose-painted radiotherapy [5].…”

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confidence: 99%

Methods for estimating the site of origin of locoregional recurrence in head and neck squamous cell carcinoma

et al. 2012

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“…Furthermore, owing to a combined effect of flap shrinkage, weight loss and post-radiation fibrosis in all cases, the surface contours moved medially inside after aligning the bony anatomy. As shown by Shakam et al, 31 the use of deformable image registration may allow better assessment of the dosimetry to the recurrent tumour volume in this setting.…”

Section: Discussionmentioning

confidence: 94%

Locoregional recurrences after post-operative volumetric modulated arc radiotherapy (VMAT) in oral cavity cancers in a resource constrained setting: experience and lessons learned

Chakraborty

Patil²,

Babu³

et al. 2015

BJR

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Cite this article as: Chakraborty S, Patil VM, Babu S, Muttath G, Thiagarajan SK. Locoregional recurrences after post-operative volumetric modulated arc radiotherapy (VMAT) in oral cavity cancers in a resource constrained setting: experience and lessons learned. Br J Radiol 2015;88:20140795. FULL PAPER Locoregional recurrences after post-operative volumetric modulated arc radiotherapy (VMAT) in oral cavity cancers in a resource constrained setting: experience and lessons learned Results: 75 patients with a median follow-up of 24 months were analysed. 41 (55%) patients had oral tongue cancers and 52 (69%) of the patients had Stage IVA cancers. The 2-year locoregional recurrence-free survival, diseasefree survival and overall survival were 88.9%, 82.1% and 80.5%, respectively. With a median time to failure of 6.5 months, five infield and three outfield failures were identified. Conclusion: A relatively low rate of outfield failure and lack of marginal failure attests to the efficacy of VMAT in such patients. Modifications to our existing target delineation policy have been proposed. Advances in knowledge: The use of standardized target delineation methods allows safe use of VMAT IMRT even in resource-constrained settings.

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Dose–volume analysis of locoregional recurrences in head and neck IMRT, as determined by deformable registration: A prospective multi-institutional trial

Cited by 29 publications

References 35 publications

Quality Assurance Assessment of Diagnostic and Radiation Therapy–Simulation CT Image Registration for Head and Neck Radiation Therapy: Anatomic Region of Interest–based Comparison of Rigid and Deformable Algorithms

Quality Assurance Assessment of Diagnostic and Radiation Therapy–Simulation CT Image Registration for Head and Neck Radiation Therapy: Anatomic Region of Interest–based Comparison of Rigid and Deformable Algorithms

Methods for estimating the site of origin of locoregional recurrence in head and neck squamous cell carcinoma

Locoregional recurrences after post-operative volumetric modulated arc radiotherapy (VMAT) in oral cavity cancers in a resource constrained setting: experience and lessons learned

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