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• W2014839876 abstract "Purpose/Objective(s)Large organ deformations occur (bladder, rectum) during prostate radiation therapy course leading to discrepancies between the planned dose and the actual delivered dose. Deformable image registration (DIR) may be used to quantify the difference between the planned dose and the cumulated dose. Dice score is commonly used to evaluate DIR but no relationship with cumulated dose accuracy has been shown. The goals of our study are: (1) to generate a biomechanical model to simulate inter-fraction deformations and corresponding CT scans; and (2) to use this model to quantify the accuracy of dose accumulation using DIR.Materials/MethodsThe anatomical phantom included the following anatomical structures: prostate, seminal vesicles, bladder and rectum. These structures were designed in ANSYS Designer and discretized in Finite Elements surfaces. The simulated organs were given typical elastic properties for the tissues (Young modulus, Poisson ratio). The initial phantom configuration was deformed by applying 11 pressure levels within the rectum and the bladder. The 12 phantom organs configurations were then embedded in the body contour and the bony anatomy taken from a real patient thereby obtaining 12 CT images. To ease the DIR, slightly different Hounsfield Units levels were given to each of the 4 organs. A planning dose distribution (PDD) was then generated in one of the CT, delivering 80 Gy in the prostate using IMRT. Dose at each fraction was obtained by shifting this PDD to correct for prostate motion. The cumulated dose was eventually calculated in 2 ways. First, the fraction doses were deformed following the simulated deformations (from the mechanical model), yielding to a cumulated dose distribution (RCDD). Secondly, the 11 numerically deformed CTs were non-rigidly registered to the reference CT with the widely used Demons algorithm. The fraction doses were accordingly deformed obtaining the estimated cumulated dose distribution (ECDD). Dice scores were calculated for each organ. Pointwise dose estimation errors (difference between RCDD and ECDD) were computed on the organ surfaces. Dose-surface histograms (DSH) were compared between PDD, RCDD and ECDD for each organ.ResultsThe minimum Dice scores after DIR were: 0.98, 0.96, and 0.98 for the prostate, the rectum and the bladder respectively. The pointwise dose estimation errors were (mean, standard deviation, maximum), in Gy: prostate: 0.16 / 1.10-3 / 0.67; rectum: 1.22 / 0.02 / 12.52; bladder: 2.0 / 0.02 / 15.4.ConclusionsDemons registration method used to estimate cumulative dose in deformable structures provides high Dice Score. However, this method may lead to large local dose estimation errors. Future work should tackle the development of more appropriate registration algorithms for dose accumulation. Purpose/Objective(s)Large organ deformations occur (bladder, rectum) during prostate radiation therapy course leading to discrepancies between the planned dose and the actual delivered dose. Deformable image registration (DIR) may be used to quantify the difference between the planned dose and the cumulated dose. Dice score is commonly used to evaluate DIR but no relationship with cumulated dose accuracy has been shown. The goals of our study are: (1) to generate a biomechanical model to simulate inter-fraction deformations and corresponding CT scans; and (2) to use this model to quantify the accuracy of dose accumulation using DIR. Large organ deformations occur (bladder, rectum) during prostate radiation therapy course leading to discrepancies between the planned dose and the actual delivered dose. Deformable image registration (DIR) may be used to quantify the difference between the planned dose and the cumulated dose. Dice score is commonly used to evaluate DIR but no relationship with cumulated dose accuracy has been shown. The goals of our study are: (1) to generate a biomechanical model to simulate inter-fraction deformations and corresponding CT scans; and (2) to use this model to quantify the accuracy of dose accumulation using DIR. Materials/MethodsThe anatomical phantom included the following anatomical structures: prostate, seminal vesicles, bladder and rectum. These structures were designed in ANSYS Designer and discretized in Finite Elements surfaces. The simulated organs were given typical elastic properties for the tissues (Young modulus, Poisson ratio). The initial phantom configuration was deformed by applying 11 pressure levels within the rectum and the bladder. The 12 phantom organs configurations were then embedded in the body contour and the bony anatomy taken from a real patient thereby obtaining 12 CT images. To ease the DIR, slightly different Hounsfield Units levels were given to each of the 4 organs. A planning dose distribution (PDD) was then generated in one of the CT, delivering 80 Gy in the prostate using IMRT. Dose at each fraction was obtained by shifting this PDD to correct for prostate motion. The cumulated dose was eventually calculated in 2 ways. First, the fraction doses were deformed following the simulated deformations (from the mechanical model), yielding to a cumulated dose distribution (RCDD). Secondly, the 11 numerically deformed CTs were non-rigidly registered to the reference CT with the widely used Demons algorithm. The fraction doses were accordingly deformed obtaining the estimated cumulated dose distribution (ECDD). Dice scores were calculated for each organ. Pointwise dose estimation errors (difference between RCDD and ECDD) were computed on the organ surfaces. Dose-surface histograms (DSH) were compared between PDD, RCDD and ECDD for each organ. The anatomical phantom included the following anatomical structures: prostate, seminal vesicles, bladder and rectum. These structures were designed in ANSYS Designer and discretized in Finite Elements surfaces. The simulated organs were given typical elastic properties for the tissues (Young modulus, Poisson ratio). The initial phantom configuration was deformed by applying 11 pressure levels within the rectum and the bladder. The 12 phantom organs configurations were then embedded in the body contour and the bony anatomy taken from a real patient thereby obtaining 12 CT images. To ease the DIR, slightly different Hounsfield Units levels were given to each of the 4 organs. A planning dose distribution (PDD) was then generated in one of the CT, delivering 80 Gy in the prostate using IMRT. Dose at each fraction was obtained by shifting this PDD to correct for prostate motion. The cumulated dose was eventually calculated in 2 ways. First, the fraction doses were deformed following the simulated deformations (from the mechanical model), yielding to a cumulated dose distribution (RCDD). Secondly, the 11 numerically deformed CTs were non-rigidly registered to the reference CT with the widely used Demons algorithm. The fraction doses were accordingly deformed obtaining the estimated cumulated dose distribution (ECDD). Dice scores were calculated for each organ. Pointwise dose estimation errors (difference between RCDD and ECDD) were computed on the organ surfaces. Dose-surface histograms (DSH) were compared between PDD, RCDD and ECDD for each organ. ResultsThe minimum Dice scores after DIR were: 0.98, 0.96, and 0.98 for the prostate, the rectum and the bladder respectively. The pointwise dose estimation errors were (mean, standard deviation, maximum), in Gy: prostate: 0.16 / 1.10-3 / 0.67; rectum: 1.22 / 0.02 / 12.52; bladder: 2.0 / 0.02 / 15.4. The minimum Dice scores after DIR were: 0.98, 0.96, and 0.98 for the prostate, the rectum and the bladder respectively. The pointwise dose estimation errors were (mean, standard deviation, maximum), in Gy: prostate: 0.16 / 1.10-3 / 0.67; rectum: 1.22 / 0.02 / 12.52; bladder: 2.0 / 0.02 / 15.4. ConclusionsDemons registration method used to estimate cumulative dose in deformable structures provides high Dice Score. However, this method may lead to large local dose estimation errors. Future work should tackle the development of more appropriate registration algorithms for dose accumulation. Demons registration method used to estimate cumulative dose in deformable structures provides high Dice Score. However, this method may lead to large local dose estimation errors. Future work should tackle the development of more appropriate registration algorithms for dose accumulation." @default.
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• W2014839876 title "How Accurate is Deformable Image Registration to Calculate Cumulative Dose From Fraction to Fraction in Prostate IGRT?" @default.
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