A novel algorithm for the morphometric assessment of radiotherapy treatment planning volumes.

Quantitative assessment of target volume contouring in radiotherapy treatment planning is an important aspect of quality assessment and educational exercises. The Conformity Index (CI) is a volume-based statistic frequently used for this purpose. Although the CI is relatively simple to understand and can be calculated using most treatment planning systems, it does not provide any information on the differences in shape between the two volumes. We present a new morphometric (shape-based) statistic known as the "mean distance to conformity" (MDC). For a specific volume that is being evaluated against a reference volume, the MDC represents the average distance that all outlying points in the volume must be moved in order to achieve perfect conformity with the reference volume. The MDC comprises a component related to under-contouring (where the evaluation volume is smaller than the reference volume) and a component related to over-contouring (where the evaluation extends beyond the reference volume). Furthermore, voxel-by-voxel information on conformity errors can also be displayed using a volume-error histogram. Calculation of MDC statistics is achieved using a three-dimensional grid search algorithm. By using a range of scenarios comprising both theoretical and actual clinical volumes, we demonstrate the increased utility of the MDC for the detection of contouring errors.