TY - JOUR
T1 - Clinical feasibility of MR-assisted CT-based cervical brachytherapy using MR-to-CT deformable image registration
AU - Dyer, Brandon A.
AU - Yuan, Zilong
AU - Qiu, Jianfeng
AU - Shi, Liting
AU - Wright, Cari
AU - Benedict, Stanley H.
AU - Valicenti, Richard
AU - Mayadev, Jyoti S
AU - Rong, Yi
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Purpose: The purpose of this study is to evaluate the feasibility of using deformable image registration algorithms to improve high-dose-rate high-risk clinical target volume (HR-CTV) delineation between preapplicator implantation MRI (pre-MRI) and postapplicator implantation CT (post-CT) in the treatment of locally advanced cervical cancer (LACC). Method and materials: Twenty-six patients were identified for the study. Regions of interest were segmented on MRI and CT. A HR-CTV was delineated on pre-MRI and compared with the previously contoured HR-CTV on the post-CT. Two commercially available algorithms, ANACONDA (anatomically constrained) and MORFEUS (biomechanical model based) with various controlling structure settings, including the cervix, uterus, etc., were used to deform pre-MRI to post-CT. MRI-to-CT deformed targets are denoted as HR-CTV’. Quantitative deformation metrics include Dice index, distance to agreement, and center of mass displacement. Qualitative clinical usefulness of deformations was scored based on HR-CTV identification on CT images. Results: For ANACONDA and MORFEUS deformations, using a cervix controlling region of interest resulted in the highest Dice, lowest distance to agreement, and lowest center of mass displacement for HR-CTV′. With MORFEUS deformations, the deformed HR-CTV’ proved clinically useful in 23 patients. Conclusions: Prebrachytherapy implantation MRI can aid target contours for CT-based brachytherapy through ANACONDA or MORFEUS algorithms with appropriate parameter selection for LACC patients.
AB - Purpose: The purpose of this study is to evaluate the feasibility of using deformable image registration algorithms to improve high-dose-rate high-risk clinical target volume (HR-CTV) delineation between preapplicator implantation MRI (pre-MRI) and postapplicator implantation CT (post-CT) in the treatment of locally advanced cervical cancer (LACC). Method and materials: Twenty-six patients were identified for the study. Regions of interest were segmented on MRI and CT. A HR-CTV was delineated on pre-MRI and compared with the previously contoured HR-CTV on the post-CT. Two commercially available algorithms, ANACONDA (anatomically constrained) and MORFEUS (biomechanical model based) with various controlling structure settings, including the cervix, uterus, etc., were used to deform pre-MRI to post-CT. MRI-to-CT deformed targets are denoted as HR-CTV’. Quantitative deformation metrics include Dice index, distance to agreement, and center of mass displacement. Qualitative clinical usefulness of deformations was scored based on HR-CTV identification on CT images. Results: For ANACONDA and MORFEUS deformations, using a cervix controlling region of interest resulted in the highest Dice, lowest distance to agreement, and lowest center of mass displacement for HR-CTV′. With MORFEUS deformations, the deformed HR-CTV’ proved clinically useful in 23 patients. Conclusions: Prebrachytherapy implantation MRI can aid target contours for CT-based brachytherapy through ANACONDA or MORFEUS algorithms with appropriate parameter selection for LACC patients.
KW - Cervical cancer
KW - Deformable image registration
KW - High-dose-rate brachytherapy
KW - Magnetic resonance imaging
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U2 - 10.1016/j.brachy.2020.03.001
DO - 10.1016/j.brachy.2020.03.001
M3 - Article
C2 - 32327343
AN - SCOPUS:85083435612
JO - Brachytherapy
JF - Brachytherapy
SN - 1538-4721
ER -