形变配准在螺旋断层治疗联合近距离治疗宫颈癌剂量叠加中的应用

doi:10.3760/cma.j.cn113030-20201206-00589

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Abstract Objective To assess the feasibility of deformable image registration (DIR) in evaluating cumulative dose distribution of bladder and rectum of cervical cancer patients during helical tomotherapy (HT)-based intensity-modulated radiotherapy (IMRT) and high-dose-rate(HDR) brachytherapy. Methods Clinical data of 18 patients were retrospectively analyzed. Cumulative bladder/rectum D2cm³ and high-risk clinical target volume (HR-CTV) D90% parameters were calculated and compared to two direct parameter-adding methods with two registration-adding methods. Equivalent uniform dose (EUD group) and overlapping high dose (OHD group) methods were employed as parameter-adding methods. The registration-adding methods including rigid image registration (RIR group) and deformable image registration (DIR group) were adopted based on a commercial image registration software (MIM Maestro®). The dice similarity coefficient (DSC) and mean distance to agreement (MDA) were measured to assess the accuracy of RIR and DIR. Results In the EUD,OHD,RIR and DIR groups, the cumulative doses of bladder/rectum D2cm³ and HR-CTV D90% were (80.11±3.59)Gy (EQD2Gy),(82.23±3.46)Gy (EQD2Gy),(80.99±6.01)Gy (EQD2Gy) and (81.19±3.11)Gy (EQD2Gy)(P=0.516);(72.90±3.58)Gy (EQD2Gy),(73.83±4.28)Gy (EQD2Gy),(72.45±6.05)Gy (EQD2Gy) and (71.98±2.89)Gy (EQD2Gy)(P=0.625), and (85.51±2.91)Gy (EQD2Gy),(87.65±3.46)Gy (EQD2Gy),(81.53±3.63)Gy (EQD2Gy) and (85.81±3.30)Gy (EQD2Gy)(P<0.001), respectively. The mean DSC of the bladder, rectum and HR-CTV were 0.69, 0.65 and 0.63 with RIR;and 0.85, 0.81 and 0.78 with DIR (P<0.001), respectively. In DIR, the average MDA of bladder, rectum, and HR-CTV were 2.88, 2.48 and 2.66mm, respectively. Conclusions The cumulative DVH parameters among 4 groups show no significant difference in the bladder/rectum D2cm³/D0.2cm³. Since the DIR group achieves satisfactory volume matching of greater than 0.8 with DSC analysis, it can yield acceptable results for clinical application between HT IMRT and HDR BT for cervical cancer.

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	Articles by authors
	Wang Wei
	Zhou Qing
	Jiang Mawei

Key words： Deformable image registration Dose evaluation Cervical neoplasm/brachytherapy Cervical neoplasm/helical tomotherapy

Received: 06 December 2020

Corresponding Authors: Jiang Mawei, Email:jiangmawei@xinhuamed.com.cn

Cite this article:

Wang Wei,Zhou Qing,Jiang Mawei. Application of deformable image registration in radiotherapy dose accumulation of helical tomotherapy combined with brachytherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(1): 59-64.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20201206-00589 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I1/59

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