Geometric discrepancy of image-guided radiation therapy in patients with prostate cancer without implanted fiducial markers using a commercial pseudo-CT generation method
MR-only simulations provide pseudo-CT images which are segmented into 5 kinds of tissues from DIXON-based images. However, it is difficult to register pseudo-CT images to cone-beam CT (CBCT) images collected for image-guided radiation therapy (IGRT), because of the lack of contrasts among tissues. We validated gaps of IGRT between pseudo-CT or planning CT and CBCT for patients without implanted markers. We also propose calcification-assisted registration for MR-only simulation. We conducted retrospective analyses to verify the registration accuracy in 15 patients who underwent volumetric modulated arc therapy (VMAT) for prostate cancer. They underwent planning CT and pseudo-CT. Pseudo-CT images after deformable image registration (DIR) to planning CT images were rendered automatic pelvic bone matching to CBCT images. Patient positions on the pseudo-CT images after DIR were shifted on the basis of tissues around the prostate. We compared registration gaps between the images of planning CT and pseudo-CT with DIR, assuming that the tissue-based matching between the planning CT and CBCT was the gold standard. To the pseudo-CT images with DIR, calcifications detected on planning CT were added. We validated IGRT accuracy for a calcification-assisted registration. The absolute registration errors of the pseudo-CT, in comparison with the planning CT, were 0.34 ± 0.50 (lateral), 1.3 ± 1.3 (longitudinal), and 1.1 ± 1.0 mm (vertical). The absolute registration errors of the pseudo-CT with calcification contouring, in comparison with the planning CT, were 0.41 ± 1.0 (lateral), 0.87 ± 0.92 (longitudinal), and 0.74 ± 0.64 mm (vertical). Reduced absolute registration errors were observed in the proposed approach in the longitudinal (P < 0.01) and vertical (P < 0.01) dimensions when using calcification-assisted registration. The tissue-based registration using the MR-only simulation was not sufficient for use in patients with prostate cancer without implanted markers. The calcification-assisted registration might help to improve IGRT accuracy using MRI alone.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
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| Enthalten in: |
Physics in medicine and biology - 64(2019), 6 vom: 08. März, Seite 06NT01 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kan, Hirohito [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.01.2020 Date Revised 23.01.2020 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1088/1361-6560/ab02cc |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM293228175 |
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| 520 | |a MR-only simulations provide pseudo-CT images which are segmented into 5 kinds of tissues from DIXON-based images. However, it is difficult to register pseudo-CT images to cone-beam CT (CBCT) images collected for image-guided radiation therapy (IGRT), because of the lack of contrasts among tissues. We validated gaps of IGRT between pseudo-CT or planning CT and CBCT for patients without implanted markers. We also propose calcification-assisted registration for MR-only simulation. We conducted retrospective analyses to verify the registration accuracy in 15 patients who underwent volumetric modulated arc therapy (VMAT) for prostate cancer. They underwent planning CT and pseudo-CT. Pseudo-CT images after deformable image registration (DIR) to planning CT images were rendered automatic pelvic bone matching to CBCT images. Patient positions on the pseudo-CT images after DIR were shifted on the basis of tissues around the prostate. We compared registration gaps between the images of planning CT and pseudo-CT with DIR, assuming that the tissue-based matching between the planning CT and CBCT was the gold standard. To the pseudo-CT images with DIR, calcifications detected on planning CT were added. We validated IGRT accuracy for a calcification-assisted registration. The absolute registration errors of the pseudo-CT, in comparison with the planning CT, were 0.34 ± 0.50 (lateral), 1.3 ± 1.3 (longitudinal), and 1.1 ± 1.0 mm (vertical). The absolute registration errors of the pseudo-CT with calcification contouring, in comparison with the planning CT, were 0.41 ± 1.0 (lateral), 0.87 ± 0.92 (longitudinal), and 0.74 ± 0.64 mm (vertical). Reduced absolute registration errors were observed in the proposed approach in the longitudinal (P < 0.01) and vertical (P < 0.01) dimensions when using calcification-assisted registration. The tissue-based registration using the MR-only simulation was not sufficient for use in patients with prostate cancer without implanted markers. The calcification-assisted registration might help to improve IGRT accuracy using MRI alone | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Eguchi, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuchiya, Takahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kondo, Takuto |e verfasserin |4 aut | |
| 700 | 1 | |a Kitagawa, Yuto |e verfasserin |4 aut | |
| 700 | 1 | |a Mekata, Yuji |e verfasserin |4 aut | |
| 700 | 1 | |a Fukuma, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshida, Ryoya |e verfasserin |4 aut | |
| 700 | 1 | |a Kasai, Harumasa |e verfasserin |4 aut | |
| 700 | 1 | |a Kunitomo, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Hirose, Yasujiro |e verfasserin |4 aut | |
| 700 | 1 | |a Shibamoto, Yuta |e verfasserin |4 aut | |
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