Abstract

Purpose:To create and characterize a reference data set for testing image registration algorithms that transform portal image (PI) to digitally reconstructed radiograph (DRR).Methods:Anterior‐posterior (AP) and Lateral (LAT) projection and DRR image pairs from nine cases representing four different anatomical sites (head and neck, thoracic, abdominal, and pelvis) were selected for this study. Five experts will perform manual registration by placing landmarks points (LMPs) on the DRR and finding their corresponding points on the PI using computer assisted manual point selection tool (CAMPST), a custom‐made MATLAB software tool developed in house. The landmark selection process will be repeated on both the PI and the DRR in order to characterize inter‐ and ‐intra observer variations associated with the point selection process. Inter and an intra observer variation in LMPs was done using Bland‐Altman (B&A) analysis and one‐way analysis of variance. We set our limit such that the absolute value of the mean difference between the readings should not exceed 3mm. Later on in this project we will test different two dimension (2D) image registration algorithms and quantify the uncertainty associated with their registration.Results:Using one‐way analysis of variance (ANOVA) there was no variations within the readers. When Bland‐Altman analysis was used the variation within the readers was acceptable. The variation was higher in the PI compared to the DRR.ConclusionThe variation seen for the PI is because although the PI has a much better spatial resolution the poor resolution on the DRR makes it difficult to locate the actual corresponding anatomical feature on the PI. We hope this becomes more evident when all the readers complete the point selection. The reason for quantifying inter‐ and ‐intra observer variation tells us to what degree of accuracy a manual registration can be done.Research supported by William Beaumont Hospital Research Start Up Fund.

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