Department of Radiation Oncology,Shandong Cancer Hospital,Ji’nan University,Shandong Academy of Medical Sciences,School of Medicine and Life Science,Ji’nan 250117,China
AbstractObjective To investigate the feasibility of defining the radiotherapy target of primary liver cancer using four-dimensional computed tomography (4DCT) and T2-weighted magnetic resonance (MR-T2) deformable image registration.Methods Ten patients with hepatocellular carcinoma (HCC) who first received radiotherapy were included in this study. The 4DCT in free breathing and MR-T2 in deep breathing were acquired sequentially. 4DCT were sorted into ten series of CT images according to the respiratory phase. MIM software was used for deformable image registration. The accuracy of deformable image registration was assessed by the maximal displacements in three-dimensional directions of the portal vein and the celiac trunk and the degree of liver overlapping (P-LIVER). Gross tumorvolume (GTV) was delineated on different series of CT images and the internal GTV (IGTV) was merged by ten GTVs on 4DCT images in each phase. The MR-T2 image was deformably registered to 4DCT images in each phase to acquire ten GTVDR. The IGTVDR was obtained by merging the ten GTVDR. The differences between different target volumes were compared by paired t-test. Results The maximal displacements in three-dimensional directions of the portal vein were 0.3±0.8 mm along the x-axis, 0.8±1.8 mm along the y-axis, and 0.5±1.5 mm along the z-axis. The maximal displacements in three-dimensional directions of the celiac trunk were 0.1±1.0 mm along the x-axis, 0.7±1.2 mm along the y-axis, and 0.6±2.0 mm along the z-axis. Overlapping degree was 115.4±13.8%. The volumes of GTVs obtained from 4DCT images in each phase after DR increased by an average of 8.18%(P<0.05), and were consistent with those delineated on MR-T2 images. The IGTV after DR increased by an average of 9.67%(P<0.05). Conclusions MRI image can show more information and have a higher contrast than CT image. MRI images should be combined with 4DCT images for delineating the GTV. It can better determine the scope and trajectory of the target and improve the delineation accuracy of HCC target.
Huang Fujing,Ma Changsheng,Wang Ruozheng et al. Application of 4DCT and MRI image deformation registration in the determination of primary liver cancer radiotherapy target[J]. Chinese Journal of Radiation Oncology, 2017, 26(5): 555-559.
Huang Fujing,Ma Changsheng,Wang Ruozheng et al. Application of 4DCT and MRI image deformation registration in the determination of primary liver cancer radiotherapy target[J]. Chinese Journal of Radiation Oncology, 2017, 26(5): 555-559.
[1] Hallman JL,Mori S,Sharp GC,et al. A four-dimensional computed tomography analysis of multi-organ abdominal motion[J].Int J Radiat Oncol Biol Phys,2012,83(1):435-441.DOI:10.1016/j.ijrobp.2011.06.1970. [2] Pech M,Mohnike K,Wieners G,et al. Radiotherapy of liver metastases. Comparison of target volumes and dose-volume histograms employing CT-or MRI-based treatment planning[J].Strahlenther Onkol,2008,184(5):256-261.DOI:10.1007/s00066-008-1849-8. [3] 任志刚,胡伟刚,蒋国梁.CT与MRI图像融合技术确定原发性肝癌三维适形放疗靶区应用研究[J].中华放射肿瘤学杂志,2009,18(1):11-14.DOI:10.3760/cma.j.issn.1004-4221.2009.01.011. Ren ZG,Hu WG,Jiang GL.Study on the application of CT and MRI image fusion in the determination of three dimensional conformal radiotherapy for primary liver cancer[J].Chin J Radiat Oncol,2009,18(1):11-14.DOI:10.3760/cma.j.issn.1004-4221.2009.01. 011. [4] Voroney JP,Brock KK,Eccles C,et al. Prospective comparison of computed tomography and magnetic resonance imaging for liver cancer delineation using deformable image registration[J].Int J Radiat Oncol Biol Phys,2006,66(3):780-791.DOI:10.1016/j.ijrobp.2006.05.035. [5] Price TR,Perkins SM,Sandrasegaran K,et al. Evaluation of response after stereotactic body radiotherapy for hepatocellular carcinoma[J].Cancer,2012,118(12):3191-3198.DOI:10.1002/cncr.26404. [6] Eccles C,Brock KK,Bissonnette JP,et al. Reproducibility of liver position using active breathing coordinator for liver cancer radiotherapy[J].Int J Radiat Oncol Biol Phys,2006,64(3):751-759.DOI:10.1016/j.ijrobp.2005.05.066. [7] Rietzel E,Chen GT,Choi NC,et al. Four-dimensional image-based treatment planning:Target volume segmentation and dose calculation in the presence of respiratory motion[J].Int J Radiat Oncol Biol Phys,2005,61(5):1535-1550.DOI:10.1016/j.ijrobp.2004.11.037. [8] Kierans S,Elazzazi M,Braga L,et al. Thermoablative treatments for malignant liver lesions:10-year experience of MRI appearances of treatment response[J].AJR,2010,194(2):523-529.DOI:10.2214/AJR.09.2621. [9] Mahmoud B,Elkholy S,Nabeel M,et al. Role of MRI in the assessment of treatment response after radiofrequency and microwave ablation therapy for hepatocellular carcinoma[J].Egyp Soc Radiol Nucl Med,2016,47(2):377-385.DOI:org/10.1016/j.ejrnm.2016.01.007. [10] 郑亚琴,田心.医学图像配准技术研究进展[J].国际生物医学工程杂志,2006,29(2):88-92.DOI:10.3760/cma.j.issn.1673-4181.2006.02.007. Zheng YQ,Tian X.Research progress of medical image registration[J].Int J Biomed Engineer,2006,29(2):88-92.DOI:10.3760/cma.j.issn.1673-4181.2006.02.007. [11] Brock KK,Lee M,Eccles CL,et al. Deformable registration and dose accumulation to investigate marginal liver cancer recurrences[J].Int J Radiat Oncol Biol Phys,2008,72(1):538.DOI:org/10.1016/j.ijrobp.2008.06.079. [12] Wijesooriya K,Weiss E,Dong L,et al. Quantifying the accuracy of automated structure segmentation in 4DCT images using a deformable image registration algorithm[J].Med Phys,2008,35(4):1251-1260.DOI:10.1118/1.2839120. [13] Jung SH,Yoon SM,Park SH,et al. Four-dimensional dose evaluation using deformable image registration in radiotherapy for liver cancer[J].Med Phys,2013,40(1):011706.DOI:10.1118/1.4769427. [14] Velec M,Moseley JL,Eccles CL,et al. Effect of breathing motion on radiotherapy dose accumulation in the abdomen using deformable registration[J].Int J Radiat Oncol Biol Phys,2011,80(1):265-272.DOI:10.1016/j.ijrobp.2010.05.023. [15] Yu Ji,Kim JS,Park HC,et al. Evaluation of anatomical landmark position differences between respiration-gated MRI and four-dimensional CT for radiation therapy in patients with hepatocellular carcinoma[J].Br J Radiol,2013,86(1021):20120221.DOI:10.1259/bjr.20120221. [16] Annemarie TF,Smith A,Lingshu Y,et al. Comparative assessment of liver tumor motion using Cine-Magnetic Resonance Imaging versus 4-Dimensional Computed Tomography[J].Int J Radiat Oncol Biol Phys,2015,91(5):1034-1040.DOI:10.1016/j.ijrobp.2014.12.048. [17] Pukala J,Perry B,Amish P,et al. Benchmarking of five commercial deformable image registration algorithms for head and neck patients[J].Med Phys,2016,17(3):25-40.DOI:10.1120/jacmp.v17i3.5735.
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