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Improving Dose Accuracy in Cancer Radiation Therapy Using Deformable Image Registration

中国医疗设备 2016年第11期31卷 9-13+22页

作者： Amy Liu Yadin David Fred Hosea Richard Wu Department of Radiation Physics University of Texas MD Anderson Cancer Center Biomedical Engineering Consultants LLC 3. Convivia

Objective To explore the differences in volume and doses to clinical target volumes (CTVs) and organs at risk (OARs) with and without adaptive treatment plans by using deformable image registration *** Ten patients with head and neck cancer were selected for this retrospective *** patient’s original treatment plan was generated using the Eclipse treatment planning system(Varian,Inc.). Verification CT scans were performed during the third week of treatment. The verification CT images were registered with the original CT images using the Eclipse rigid registration tool simulating daily patient treatment alignment. Then, deformable image registrations (Velocity, Inc.) were performed between the two CT image sets,and the CTVs and major OARs were transferred from the original CT images to the verification CT images. The original treatment plan was then copied into the verification CT image set to calculate the radiation dose reflecting the most recent anatomic changes. Verification plan doses were evaluated by a radiation oncologist,who determined whether an adaptive treatment plan was *** compared the accumulated doses to CTVs and OARs between the original and adaptive plans,as well as between the adaptive and verification plans, to simulate the doses that would have been delivered if the adaptive plans were not *** dosimetric data were extracted using the Eclipse Application Programming Interface tool,which was developed in house to access the Eclipse *** Body contours were different after 3 weeks of *** volumes of all CTVs were reduced(P≤0.04), and the volumes of left and right parotid glands decreased(P≤0.004). There were no significant differences in the volumes of brainstem and oral cavity(P≥0.14) between the original and verification CT *** spinal cord had a mean 8.7%decrease in volume(P=0.04). Mean doses of CTVs were all decreased(P≤0.04), whereas the mean doses of the right parotid and oral cavity

关键词： deformable image registration proton IMPT for head and neck cancer adaptive plan dose uncertainty

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