Abstract

Purpose: To evaluate the accuracy of deformable image registration (DIR) between the planning kVCT (pCT) and the daily MVCT combined with the histogram matching (HM) algorithm, and evaluate the deformable dose accumulation using a suggested method for adaptive radiotherapy with Helical Tomotharapy (HT). Methods: For five prostate cancer patients (76 Gy/38 Fr) treated with HT in our institution, seven MVCT series (a total of 35 series) acquired weekly were investigated. First, to minimize the effect of different HU values between pCT and MVCT, this image-processing method adjusts HU values between pCT and MVCT images by using image cumulative histograms of HU values, generating an HM-MVCT. Then, the DIR of the pCT to the HM-MVCT was performed, generating a deformed pCT. Finally, deformable dose accumulation was performed toward the pCT image. Results: The accuracy of DIR was significantly improved by using the HM algorithm, compared with non-HM method for several structures (p < 0.05). The mean dice similarity coefficient of the non-HM method was 0.75 ± 0.05, 0.83 ± 0.06, and 0.90 ± 0.04 for the CTV, rectum, and bladder, respectively, while that of the HM method was 0.81 ± 0.06, 0.81 ± 0.04, and 0.92 ± 0.06, respectively. For the deformable dose accumulation, some difference was observed between the two methods, particularly for the small calculated regions, such as rectum V60 and V70. Conclusion: Adapting the HM method can improve the accuracy of DIR. Furthermore, dose calculation using the deformed pCT using HM methods can be an effective tool for adaptive radiotherapy.

Highlights

  • Intensity modulated radiotherapy (IMRT) using helical tomotherapy (HT) (Accuray, Sunnyvale, CA) reduces the radiation dose to organs at risks (OAR) while maintaining conformity of the tumor [1]

  • To evaluate the accuracy of deformable image registration (DIR) between the planning kVCT and the daily mega-voltage computed tomography (MVCT) combined with the histogram matching (HM) algorithm, and evaluate the deformable dose accumulation using a suggested method for adaptive radiotherapy with Helical Tomotharapy (HT)

  • Adapting the HM method can improve the accuracy of DIR

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Summary

Introduction

Intensity modulated radiotherapy (IMRT) using helical tomotherapy (HT) (Accuray, Sunnyvale, CA) reduces the radiation dose to organs at risks (OAR) while maintaining conformity of the tumor [1]. Some studies on adaptive radiotherapy using the daily MVCT and deformable image registration (DIR) have been published [3] [4] [5] [6]. Branchini et al suggested a method of planning CT (pCT) for daily MVCT deformation and evaluated its accuracy [7]. They suggested that the method might be sufficiently fast and reliable for daily delivered dose evaluations in clinical strategies for adaptive radiotherapy using HT. The poor image quality of MVCT might decrease the accuracy of DIR and dose calculation. Several authors introduced denoising methods [3], further evaluation for more accurate ART methods using MVCT is needed

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