Abstract
To compare the reliability and the required time for two cone-beam CT (CBCT) registration methods for prostate irradiation (PI) and prostate bed irradiation (PBI). Two-hundred treatment fractions (in 10 PI and 10 PBI patients) were reanalyzed, using two CBCT registration methods: (1) a combination of an automated chamfer matching (CM) with manual matching (MM), and (2) the automated XVI dual registration tool (DRT). Bland-Altman 95% Limits of Agreement (LoA) were used to assess agreement with manual registration by Radiation Oncologists. All 95% LoA for CM+MM were≤0.33cm. For DRT, several 95% LoA were notably larger than the predefined clinical threshold of 0.3cm: -0.47 to +0.25cm (PI) and -0.36 to +0.23cm (PBI) for the superior-inferior direction and -0.52 to +0.24cm (PI) and -0.38 to +0.31cm (PBI) for the anterior-posterior direction.For PI, the average time required was 33s with CM+MM versus only 18s with DRT (p=0.002). For PBI, this was 13 versus 19s, respectively (p=0.16). For PI, DRT was significantly faster than CM+MM, but the accuracy is insufficient to use without manual verification. Therefore, manual verification is still warranted, but could offset the time benefit. For PBI, the CM+MM method was faster and more accurate.
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