A Method for Predicting Dose Changes for HN Treatment Using Surface Imaging

Head and neck cancer is commonly treated with a six- to seven-week course of radiotherapy, during which a patient’s anatomy may change substantially, due to target reduction or weight loss. Anatomical changes lead to reduction in treatment quality due to decreased setup reproducibility and altered dose deposition compared to the original plan. Few clinics have developed a standard method for triggering resimulation and replan due to anatomic changes. This work investigates a new method for determining when to resimulate and replan HNC patients by utilizing their topographic anatomical changes to predict differences in planned versus delivered dose distributions. The first part of the work presents a method for deformable image registration of CT to CBCT which addresses the challenges of inaccurate Hounsfield units and truncated field of view present in CBCT. The registration method was validated on 10 HN patients using contour comparison, with average DSC of 0.82, 0.74, 0.72, and 0.69 for mandible, cord, and left and right parotid. The registration method was then used to generate dose maps and surface contours for 47 patients for the second part of this work, the development of a U-Net which takes the original dose distribution, the original surface, and the treatment day surface as input and predicts the treatment day dose distribution as output. The average RMSE and MAE between the true and predicted dose distributions for a test set of 6 patients was 4.25 and 2.15. This work proves feasibility of a dose prediction neural network using surface imaging

Towards Robust and Accurate Image Registration by Incorporating Anatomical and Appearance Priors

Ph.DDOCTOR OF PHILOSOPH

Landmark-Matching Transformation with Large Deformation Via n-dimensional Quasi-conformal Maps

We propose a new method to obtain landmark-matching transformations between n-dimensional Euclidean spaces with large deformations. Given a set of feature correspondences, our algorithm searches for an optimal folding-free mapping that satisfies the prescribed landmark constraints. The standard conformality distortion defined for mappings between 2-dimensional spaces is first generalized to the n-dimensional conformality distortion K(f) for a mapping f between n-dimensional Euclidean spaces (n ≥ 3). We then propose a variational model involving K(f) to tackle the landmark-matching problem in higher dimensional spaces. The generalized conformality term K(f) enforces the bijectivity of the optimized mapping and minimizes its local geometric distortions even with large deformations. Another challenge is the high computational cost of the proposed model. To tackle this, we have also proposed a numerical method to solve the optimization problem more efficiently. Alternating direction method with multiplier is applied to split the optimization problem into two subproblems. Preconditioned conjugate gradient method with multi-grid preconditioner is applied to solve one of the sub-problems, while a fixed-point iteration is proposed to solve another subproblem. Experiments have been carried out on both synthetic examples and lung CT images to compute the diffeomorphic landmark-matching transformation with different landmark constraints. Results show the efficacy of our proposed model to obtain a folding-free landmark-matching transformation between n-dimensional spaces with large deformations

Deformable Medical Image Registration: A Survey

Deformable image registration is a fundamental task in medical image processing. Among its most important applications, one may cite: i) multi-modality fusion, where information acquired by different imaging devices or protocols is fused to facilitate diagnosis and treatment planning; ii) longitudinal studies, where temporal structural or anatomical changes are investigated; and iii) population modeling and statistical atlases used to study normal anatomical variability. In this technical report, we attempt to give an overview of deformable registration methods, putting emphasis on the most recent advances in the domain. Additional emphasis has been given to techniques applied to medical images. In order to study image registration methods in depth, their main components are identified and studied independently. The most recent techniques are presented in a systematic fashion. The contribution of this technical report is to provide an extensive account of registration techniques in a systematic manner.Le recalage déformable d'images est une des tâches les plus fondamentales dans l'imagerie médicale. Parmi ses applications les plus importantes, on compte: i) la fusion d' information provenant des différents types de modalités a n de faciliter le diagnostic et la planification du traitement; ii) les études longitudinales, oú des changements structurels ou anatomiques sont étudiées en fonction du temps; et iii) la modélisation de la variabilité anatomique normale d'une population et les atlas statistiques. Dans ce rapport de recherche, nous essayons de donner un aperçu des différentes méthodes du recalage déformables, en mettant l'accent sur les avancées les plus récentes du domaine. Nous avons particulièrement insisté sur les techniques appliquées aux images médicales. A n d'étudier les méthodes du recalage d'images, leurs composants principales sont d'abord identifiés puis étudiées de manière indépendante, les techniques les plus récentes étant classifiées en suivant un schéma logique déterminé. La contribution de ce rapport de recherche est de fournir un compte rendu détaillé des techniques de recalage d'une manière systématique

A Heterogeneous and Multi-Range Soft-Tissue Deformation Model for Applications in Adaptive Radiotherapy

During fractionated radiotherapy, anatomical changes result in uncertainties in the applied dose distribution. With increasing steepness of applied dose gradients, the relevance of patient deformations increases. Especially in proton therapy, small anatomical changes in the order of millimeters can result in large range uncertainties and therefore in substantial deviations from the planned dose. To quantify the anatomical changes, deformation models are required. With upcoming MR-guidance, the soft-tissue deformations gain visibility, but so far only few soft-tissue models meeting the requirements of high-precision radiotherapy exist. Most state-of-the-art models either lack anatomical detail or exhibit long computation times. In this work, a fast soft-tissue deformation model is developed which is capable of considering tissue properties of heterogeneous tissue. The model is based on the chainmail (CM)-concept, which is improved by three basic features. For the first time, rotational degrees of freedom are introduced into the CM-concept to improve the characteristic deformation behavior. A novel concept for handling multiple deformation initiators is developed to cope with global deformation input. And finally, a concept for handling various shapes of deformation input is proposed to provide a high flexibility concerning the design of deformation input. To demonstrate the model flexibility, it was coupled to a kinematic skeleton model for the head and neck region, which provides anatomically correct deformation input for the bones. For exemplary patient CTs, the combined model was shown to be capable of generating artificially deformed CT images with realistic appearance. This was achieved for small-range deformations in the order of interfractional deformations, as well as for large-range deformations like an arms-up to arms-down deformation, as can occur between images of different modalities. The deformation results showed a strong improvement in biofidelity, compared to the original chainmail-concept, as well as compared to clinically used image-based deformation methods. The computation times for the model are in the order of 30 min for single-threaded calculations, by simple code parallelization times in the order of 1 min can be achieved. Applications that require realistic forward deformations of CT images will benefit from the improved biofidelity of the developed model. Envisioned applications are the generation of plan libraries and virtual phantoms, as well as data augmentation for deep learning approaches. Due to the low computation times, the model is also well suited for image registration applications. In this context, it will contribute to an improved calculation of accumulated dose, as is required in high-precision adaptive radiotherapy

Integration of New Features for Telerobotic Surgery into The Mirosurge System

International audienc