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Uncertainty Evaluation of CT Image Deformable Registration for H&N Cancer Adaptive Radiotherapy


A Qin

A Qin*, D Yan , William Beaumont Hospital, Royal Oak, MI

Presentations

MO-C-17A-13 Monday 10:15AM - 12:15PM Room: 17A

Purpose:
To evaluate uncertainties of organ specific Deformable Image Registration (DIR) for H&N cancer Adaptive Radiation Therapy (ART).

Methods:
A commercial DIR evaluation tool, which includes a digital phantom library of 8 patients, and the corresponding "Ground truth Deformable Vector Field" (GT-DVF), was used in the study. Each patient in the phantom library includes the GT-DVF created from a pair of CT images acquired prior to and at the end of the treatment course. Five DIR tools, including 2 commercial tools (CMT1, CMT2), 2 in-house (IH_FFD1, IH_FFD2), and a classic DEMON algorithms, were applied on the patient images. The resulting DVF was compared to the GT-DVF voxel by voxel. Organ specific DVF uncertainty was calculated for 10 ROIs: Whole Body, Brain, Brain Stem, Cord, Lips, Mandible, Parotid, Esophagus and Submandibular Gland. Registration error-volume histogram was constructed for comparison.

Results:
The uncertainty is relatively small for brain stem, cord and lips, while large in parotid and submandibular gland. CMT1 achieved best overall accuracy (on whole body, mean vector error of 8 patients: 0.98±0.29 mm). For brain, mandible, parotid right, parotid left and submandibular glad, the classic Demon algorithm got the lowest uncertainty (0.49±0.09, 0.51±0.16, 0.46±0.11, 0.50±0.11 and 0.69±0.47 mm respectively). For brain stem, cord and lips, the DVF from CMT1 has the best accuracy (0.28±0.07, 0.22±0.08 and 0.27±0.12 mm respectively). All algorithms have largest right parotid uncertainty on patient#7, which has image artifact caused by tooth implantation.

Conclusion:
Uncertainty of deformable CT image registration highly depends on the registration algorithm, and organ specific. Large uncertainty most likely appears at the location of soft-tissue organs far from the bony structures. Among all 5 DIR methods, the classic DEMON and CMT1 seem to be the best to limit the uncertainty within 2mm for all OARs.

Funding Support, Disclosures, and Conflict of Interest: Partially supported by research grant from Elekta.


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