Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

Osorio, Eliana Vásquez; Kolkman-Deurloo, I.K.K.; Schuring-Pereira, Mônica; Zolnay, András; Heijmen, B.; Hoogeman, M.

doi:10.1118/1.4903300

Cited by 23 publications

(18 citation statements)

References 36 publications

(46 reference statements)

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“…Consequently, the dosimetric uncertainties via EBRT-BT DIR might be possibly even larger than that summed without deformation. There are several reported attempts to address this issue [ 48 , 49 ], for example, Berendsen et al [ 48 ] proposed a DIR with penalty term that minimizes the volume of the missing structure for cervical MR images with and without applicator. Vasquez Osorio et al [ 49 ] validated a structure-wise registration with vector field integration to map the largely deformed anatomies between EBRT and BT.…”

Section: Discussionmentioning

confidence: 99%

Investigating rectal toxicity associated dosimetric features with deformable accumulated rectal surface dose maps for cervical cancer radiotherapy

Chen

Zhong

et al. 2018

Radiat Oncol

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BackgroundBetter knowledge of the dose-toxicity relationship is essential for safe dose escalation to improve local control in cervical cancer radiotherapy. The conventional dose-toxicity model is based on the dose volume histogram, which is the parameter lacking spatial dose information. To overcome this limit, we explore a comprehensive rectal dose-toxicity model based on both dose volume histogram and dose map features for accurate radiation toxicity prediction.MethodsForty-two cervical cancer patients treated with combined external beam radiotherapy (EBRT) and brachytherapy (BT) were retrospectively studied, including 12 with Grade ≥ 2 rectum toxicity and 30 patients with Grade 0–1 toxicity (non-toxicity patients). The cumulative equivalent 2-Gy rectal surface dose was deformably summed using the deformation vector fields obtained through a recent developed local topology preserved non-rigid point matching algorithm. The cumulative three-dimensional (3D) dose was flattened and mapped to a two-dimensional (2D) plane to obtain the rectum surface dose map (RSDM). The dose volume parameters (DVPs) were calculated from the 3D rectum surface, while the texture features and the dose geometric parameters (DGPs) were extracted from the 2D RSDM. Representative features further computed from DVPs, textures and DGPs by principle component analysis (PCA) and statistical analysis were respectively fed into a support vector machine equipped with a sequential feature selection procedure. The predictive powers of the representative features were compared with the GEC-ESTRO dosimetric parameters D0.1/1/2cm3.ResultsSatisfactory predictive accuracy of sensitivity 74.75 and 84.75%, specificity 72.67 and 79.87%, and area under the receiver operating characteristic curve (AUC) 0.82 and 0.91 were respectively achieved by the PCA features and statistical significant features, which were superior to the D0.1/1/2cm3 (AUC 0.71). The relative area in dose levels of 64Gy, 67Gy, 68Gy, 87Gy, 88Gy and 89Gy, perimeters in dose levels of 89Gy, as well as two texture features were ranked as the important factors that were closely correlated with rectal toxicity.ConclusionsOur extensive experimental results have demonstrated the feasibility of the proposed scheme. A future large patient cohort study is still needed for model validation.Electronic supplementary materialThe online version of this article (10.1186/s13014-018-1068-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Investigating rectal toxicity associated dosimetric features with deformable accumulated rectal surface dose maps for cervical cancer radiotherapy

Chen

Zhong

et al. 2018

Radiat Oncol

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“…2,5 However, crude addition of doses or parameters may not be accurate where there is anatomical deformation and shrinkage. 2,6 Deformable image registration (DIR) can be applied to adjust for deformation and shrinkage. [6][7][8] Accumulated dose parameters can then be obtained via addition of deformably registered dose distributions.…”

Section: Introductionmentioning

confidence: 99%

“…2,6 Deformable image registration (DIR) can be applied to adjust for deformation and shrinkage. [6][7][8] Accumulated dose parameters can then be obtained via addition of deformably registered dose distributions. 2,9 The assumption that DVH-based addition provides the 'worst possible' peak rectal doses 2 should be investigated in the presence of localised contouring inconsistencies and registration inaccuracies, which could lead to registrations providing greater nearmaximum doses.…”

Section: Introductionmentioning

confidence: 99%

Accumulation of rectum dose‐volume metrics for prostate external beam radiotherapy combined with brachytherapy: Evaluating deformably registered dose distribution addition using parameter‐based addition

et al. 2017

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“…This transformation describes how the HDR-BT image can map onto the EBRT image, which can be used to model the dose transformation between EBRT and HDR-BT for radiation dose accumulation [21]. Fig 2 shows the flowchart for creating dose accumulation via dose transformation.…”

Section: Methodsmentioning

confidence: 99%

“…Osorio et al . [21] registered several pairs of critical organs individually by segmentation and then combined all the individual registration results to obtain the final deformation field. However, the resulting deformation is not guaranteed to be diffeomorphic without constraining the individual transformation to be coherent.…”

Section: Introductionmentioning

confidence: 99%

FZUImageReg: A toolbox for medical image registration and dose fusion in cervical cancer radiotherapy

et al. 2017

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The combination external-beam radiotherapy and high-dose-rate brachytherapy is a standard form of treatment for patients with locally advanced uterine cervical cancer. Personalized radiotherapy in cervical cancer requires efficient and accurate dose planning and assessment across these types of treatment. To achieve radiation dose assessment, accurate mapping of the dose distribution from HDR-BT onto EBRT is extremely important. However, few systems can achieve robust dose fusion and determine the accumulated dose distribution during the entire course of treatment. We have therefore developed a toolbox (FZUImageReg), which is a user-friendly dose fusion system based on hybrid image registration for radiation dose assessment in cervical cancer radiotherapy. The main part of the software consists of a collection of medical image registration algorithms and a modular design with a user-friendly interface, which allows users to quickly configure, test, monitor, and compare different registration methods for a specific application. Owing to the large deformation, the direct application of conventional state-of-the-art image registration methods is not sufficient for the accurate alignment of EBRT and HDR-BT images. To solve this problem, a multi-phase non-rigid registration method using local landmark-based free-form deformation is proposed for locally large deformation between EBRT and HDR-BT images, followed by intensity-based free-form deformation. With the transformation, the software also provides a dose mapping function according to the deformation field. The total dose distribution during the entire course of treatment can then be presented. Experimental results clearly show that the proposed system can achieve accurate registration between EBRT and HDR-BT images and provide radiation dose warping and fusion results for dose assessment in cervical cancer radiotherapy in terms of high accuracy and efficiency.

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Improving anatomical mapping of complexly deformed anatomy for external beam radiotherapy and brachytherapy dose accumulation in cervical cancer

Cited by 23 publications

References 36 publications

Investigating rectal toxicity associated dosimetric features with deformable accumulated rectal surface dose maps for cervical cancer radiotherapy

Investigating rectal toxicity associated dosimetric features with deformable accumulated rectal surface dose maps for cervical cancer radiotherapy

Accumulation of rectum dose‐volume metrics for prostate external beam radiotherapy combined with brachytherapy: Evaluating deformably registered dose distribution addition using parameter‐based addition

FZUImageReg: A toolbox for medical image registration and dose fusion in cervical cancer radiotherapy

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