Abstract

Breast cancer is one of the most common malignancies in women. The prone position in Partial Breast Irradiation (PBI) can better protect the heart and lung during radiotherapy. Supine position is used for CT imaging during treatment planning. The posture change in these two different positions may cause large deformation of breast, which make breast registration become a great challenge. Existing registration approaches for supine and prone breast images mainly use biomechanical modeling and iterative deformable images registration methods. However, the ability of these methods to capture such large deformations is limited. To tackle these problems, we propose an end-to-end residual recursive cascade network (RRCN) for supine and prone breast images registration. Unlike traditional deep learning networks, an affine subnetwork and several deformable subnetworks are trained together, enabling cooperation between subnetworks. Moreover, by using residual network connection, we can accelerate registration speed and reduce radiation dose. Registration accuracy is evaluated by visualizing registered images and computing normalized cross correlation (NCC). The experiment results show that RRCN with an average NCC of 0.982 ± 0.010 outperform VoxelMorph with an average NCC of 0.769 ± 0.070 and Recursive Cascaded Networks (RCN) with an average NCC of 0.914 ± 0.063, demonstrating the superior performance of the proposed method for supine and prone breast image registration. Because accurate deformable registration for this large-scale deformation is of great importance to the success of breast cancer radiotherapy, RRCN method has a strong potential to be a promising tool for future clinical practice in breast cancer radiotherapy.

Highlights

  • Breast cancer is one of the most common malignancies in women

  • Through a controlled study of breast cancer radiotherapy using supine position and prone position, the results showed that if the target area was only limited to the breast, prone position can better protect the heart and lung during radiotherapy

  • Supine position is used for Computed Tomography(CT) imaging during treatment planning because it has the following advantages: supine setup is patient-friendly; supine setup repeatability is superior than prone; cone beam CT (CBCT) setup increases daily patient dose

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Summary

INTRODUCTION

Breast cancer is one of the most common malignancies in women. Breast conservation therapy (BCT) has become a routine model of early breast cancer treatment in the world. Previous studies [8]–[10] have shown that using intensity-based deformable images registration methods cannot generate physically plausible deformations of the breast, but by approximating this motion as a sliding motion, registration performance can be improved [11]–[13]. The hybrid method of the biomechanical model and intensity-based deformable images registration method shows great potential in breast images registration [16]. No AI-based registration methods have been used for supine and prone breast images registration. We need to investigate a novel DL network which is more suitable for supine and prone breast images registration. To tackle the problem of supine and prone breast images registration, we proposed an unsupervised end-to-end residual recursive cascaded network (RRCN) based on DL in this article.

ARCHITECTURES OF AFFINE AND DEFORMABLE REGISTRATION SUBNETWORK
TRAINING PROCESSES AND HYPERPARAMETER SETTINGS
EVALUATION OF REGISTRATION PERFORMANCE
BASELINE METHODS We compare our approach with two registration methods
DISCUSSIONS
CONCLUSION
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