Ruta Zukauskaite1,2, Carsten Brink3,4, Christian Rønn Hansen4,5, Anders Bertelsen4,5, Jørgen Johansen6, Cai Grau7, Jesper Grau Eriksen6. 1. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. ruta.zukauskaite@rsyd.dk. 2. Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, C 5000, Odense, Denmark. ruta.zukauskaite@rsyd.dk. 3. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. 4. Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark. 5. Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, Australia. 6. Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, C 5000, Odense, Denmark. 7. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Abstract
BACKGROUND: Clinical application of deformable registration (DIR) of medical images remains limited due to sparse validation of DIR methods in specific situations, e. g. in case of cancer recurrences. In this study the accuracy of DIR for registration of planning CT (pCT) and recurrence CT (rCT) images of head and neck squamous cell carcinoma (HNSCC) patients was evaluated. PATIENTS AND MATERIALS: Twenty patients treated with definitive IMRT for HNSCC in 2010-2012 were included. For each patient, a pCT and an rCT scan were used. Median interval between the scans was 8.5 months. One observer manually contoured eight anatomical regions-of-interest (ROI) twice on pCT and once on rCT. METHODS: pCT and rCT images were deformably registered using the open source software elastix. Mean surface distance (MSD) and Dice similarity coefficient (DSC) between contours were used for validation of DIR. A measure for delineation uncertainty was estimated by assessing MSD from the re-delineations of the same ROI on pCT. DIR and manual contouring uncertainties were correlated with tissue volume and rigidity. RESULTS: MSD varied 1-3 mm for different ROIs for DIR and 1-1.5 mm for re-delineated ROIs performed on pCT. DSC for DIR varied between 0.58 and 0.79 for soft tissues and was 0.79 or higher for bony structures, and correlated with the volumes of ROIs (r = 0.5, p < 0.001) and tissue rigidity (r = 0.54, p < 0.001). CONCLUSION: DIR using elastix in HNSCC on planning and recurrence CT scans is feasible; an uncertainty of the method is close to the voxel size length of the planning CT images.
BACKGROUND: Clinical application of deformable registration (DIR) of medical images remains limited due to sparse validation of DIR methods in specific situations, e. g. in case of cancer recurrences. In this study the accuracy of DIR for registration of planning CT (pCT) and recurrence CT (rCT) images of head and neck squamous cell carcinoma (HNSCC) patients was evaluated. PATIENTS AND MATERIALS: Twenty patients treated with definitive IMRT for HNSCC in 2010-2012 were included. For each patient, a pCT and an rCT scan were used. Median interval between the scans was 8.5 months. One observer manually contoured eight anatomical regions-of-interest (ROI) twice on pCT and once on rCT. METHODS: pCT and rCT images were deformably registered using the open source software elastix. Mean surface distance (MSD) and Dice similarity coefficient (DSC) between contours were used for validation of DIR. A measure for delineation uncertainty was estimated by assessing MSD from the re-delineations of the same ROI on pCT. DIR and manual contouring uncertainties were correlated with tissue volume and rigidity. RESULTS: MSD varied 1-3 mm for different ROIs for DIR and 1-1.5 mm for re-delineated ROIs performed on pCT. DSC for DIR varied between 0.58 and 0.79 for soft tissues and was 0.79 or higher for bony structures, and correlated with the volumes of ROIs (r = 0.5, p < 0.001) and tissue rigidity (r = 0.54, p < 0.001). CONCLUSION: DIR using elastix in HNSCC on planning and recurrence CT scans is feasible; an uncertainty of the method is close to the voxel size length of the planning CT images.
Entities:
Keywords:
Computed tomography; Validation; elastix; head and neck
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