Behrens, C.F.

Eiland, R.B.

Maare, C.

Paulsen, Rasmus Reinhold

Samsøe, E.

Sjöström, D.

Online Research Database In Technology

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Downloaded from orbit.dtu.dk on: Dec 20, 2017Adaptive RT for H&N Cancer: The Usefulness of Deformable Image RegistrationBehrens, C.F.; Eiland, R.B.; Sjöström, D.; Maare, C.; Paulsen, Rasmus Reinhold; Samsøe, E.Publication date:2012Link back to DTU OrbitCitation (APA):Behrens, C. F., Eiland, R. B., Sjöström, D., Maare, C., Paulsen, R. R., & Samsøe, E. (2012). Adaptive RT forH&N Cancer: The Usefulness of Deformable Image Registration. Poster session presented at American Societyfor Radiation Oncology 54th Annual Meeting, ASTRO's 54th Annual Meeting, Boston, MA, United States.Adaptive RT for H&N cancer: The usefulness of deformable image registrationC. F. Behrens*1, R. B. Eiland1, D. Sjöström1, C. Maare1, R. R. Paulsen2, and E. Samsøe11 Copenhagen University Hospital, Herlev, Denmark. 2 Technical University of Denmark, Kgs. Lyngby, Denmark.*Corresponding author: clbe@heh.regionh.dkHerlev HospitalPURPOSE/OBJECTIVESTo carry out geometric and dosimetric evaluation of adaptive H&N IMRT based on a deformable image registration algorithm.Deformable image registration(Varian SmartAdapt v11)Dose calculation: AAA(Varian Eclipse)RESULTSGeometric resultsRelative volume differences between dCT and ReCT, CMS (Center of Mass shifts) and DSC (Dice Similarity Coefficient)CONCLUSIONSDeformable image registration may be used as a tool for evaluating the need for replanning. However, deformed structures should, at this point, not replace manually delineated structures.MATERIALS/METHODS•	Planning CT: pCT•	Rescan CT: ReCT•	Cone beam CT: CBCT pCT was deformed to match the CBCT resulting in deformed structures and deformed CT: dCTList of patients indicating at which fraction the CBCT and ReCT were acquired.7 H&N patientsIMRTPresented at ASTRO’s 54th Annual Meeting, October 28 – 31, 2012, BostonPatient Diagnosis site Dose Fractions CBCT ReCTID [Gy] [Frac] [Frac]1 c. occultus Sin 68 34 17 182 c. oropharyngis Dxt 68 34 17 173 c. cavi oris Sin 68 34 17 174 c. oropharyngis Dxt 68 34 18 185 c. oropharyngis Sin 66 33 29 296 c. oropharyngis Sin 68 34 24 247 c. oropharyngis Dxt 68 34 23 22Site: Primary site of the tumour. Dose: prescribed dose. Fractions: Total number of treatment fractions. CBCT [Frac]:Fraction at which the CBCT was acquired. ReCT [Frac]: Fraction at which the ReCT was acquired. Occult: Origin oftumour unknown.1Structure Relative volume CMS DSC(♯ of pt.) difference [%] [cm] [%]presented as: median value (range)GTV-T(5) 1.9 (-9.5; 62.1) 0.25 (0.11; 0.73) 0.71 (0.59; 0.86)CTV-T(5) 1.6 (-6.3; 8.9) 0.36 (0.14; 0.38) 0.86 (0.75; 0.93)GTV-N dxt(4) -15.7 (-66.7; 31.3) 0.19 (0.14; 0.35) 0.72 (0.53; 0.79)CTV-N dxt(4) 6.2 (-16.8; 17.1) 0.15 (0.13; 0.20) 0.86 (0.85; 0.93)GTV-N sin(4) 4.6 (-17.1; 50.0) 0.28 (0.12; 0.52) 0.64 (0.46; 0.76)CTV-N sin(4) 7.6 (-18.5; 137.6) 0.40 (0.08; 0.57) 0.80 (0.55; 0.91)Parotid dxt(7) -12.1 (-28.2; 18.8) 0.30 (0.20; 0.50) 0.78 (0.71; 0.83)Parotid sin(7) -13.3 (-25.1; 18.5) 0.33 (0.18; 0.56) 0.76 (0.69; 0.79)Spinal cord(7) -24.4 (-30.6; 30.4) 0.45 (0.07; 1.0) 0.73 (0.62; 0.78)∗Volume relative to ReCTpt.= Patients; DSC = Dice similarity coefficient; CMS = Center of mass shift; GTV-T = gross tumour volume-tumour;GTV-N = gross tumour volume-node; CTV-T/N= clinical target volume-tumour/node.1Dosimetric resultsConformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 (1.2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTVV95(3)V95 = Volume cove d by the 95% isodoseVPTV = Volume of the PTVVPTVa d95 = V95 ∩ VPTVV95subPTV = V95 \ VPTVDS C = 2(VReCT ∩ VdCT )VReCT + VdCT (4)1Conformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 (1.2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTVV95(3)V95 = Volume covered by the 95% isodoseVPTV = Volume of the PTVVPTVand95 = V95 ∩ VPTVV95subPTV = V95 \ VPTVDS C = 2(VReCT ∩ VdCT )VReCT + VdCT (4)1Conformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 (1.2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTVV95(3)V95 = Volume covered by the 95% isodoseVPTV = Volume of the PTVVPTVand95 = V95 ∩ VPTVV95sub TV = V95 \ VPTVDS C = 2(VReCT ∩ VdCT )VReCT + VdCT (4)1Conformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 (1.2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTVV95(3)V95 = olume covered by the 95% isodoseVPTV = Volume of the PTVVPTVand95 = V95 ∩ VPTVV95subPTV = V95 \ VPTVDS C = 2(VReCT ∩ VdCT )VReCT + VdCT (4)1Conformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 ( .2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTV95(3)V95 = Volume covered by the 95% isodoseVPTV = Volume of the PTVVPTVand95 = V95 ∩ VPTVV95subPTV = V95 \ VPTVDS C = 2(VReC ∩ VdCT )VReCT + VdCT (4)1Conformity measure pCT dCT ReCT[%] [%] [%]presented as: median value (range)CI (Conformity Index) 1.3 (1.0; 1.3) 1.3 (1.2; 1.4) 1.5 (1.1; 1.9)LCF (Lesion Coverage Fraction) 1.0 (0.95; 1.0) 0.95 (0.94; 0.99) 0.96 (0.94; 1.0)NTOF (Normal Tissue Overdosage Fraction) 0.19 (0.04; 0.20) 0.26 (0.14; 0.29) 0.32 (0.13; 0.49)pt. = Patients; CI = conformity Index; NTOF = Normal tissue overdosage fraction; LCF = Lesion coverage fractionCI = V95VPTV(1)LCF = VPTVand95VPTV(2)NTOF = V95subPTVV95(3)V95 = Volume covered by the 95% isodoseVPTV = Volume of the PTVVPTVand95 = V95 ∩ VPTVV95subPTV = V95 \ VPTVDS C = 2(VReCT ∩ VdCT )VReCT + VdCT (4)1

Adaptive RT for H&amp;N Cancer: The Usefulness of Deformable Image Registration

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Adaptive RT for H&N Cancer: The Usefulness of Deformable Image Registration

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Adaptive RT for H&amp;N Cancer: The Usefulness of Deformable Image Registration

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Adaptive RT for H&N Cancer: The Usefulness of Deformable Image Registration