Comparison between manual and automatic image registration in image-guided radiation therapy using megavoltage cone-beam computed tomography with an imaging beam line for prostate cancer
- 60 Downloads
This study aimed to compare and assess the compatibility of the bone-structure-based manual and maximization of mutual information (MMI)-algorithm-based automatic image registration using megavoltage cone-beam computed tomography (MV-CBCT) images acquired with an imaging beam line. A total of 1163 MV-CBCT images from 30 prostate cancer patients were retrospectively analyzed. The differences between setup errors in three directions (left–right, LR; superior–inferior, SI; anterior–posterior, AP) of both registration methods were investigated. Pearson’s correlation coefficients (r) and Bland–Altman agreements were evaluated. Agreements were defined by a bias close to zero and 95% limits of agreement (LoA) less than ± 3 mm. The cumulative frequencies of the absolute differences between the two registration methods were calculated to assess the distributions of the setup error differences. There were significant differences (p < 0.001) in the setup errors between both registration methods. There were moderate (SI, r = 0.45) and strong positive correlation coefficients (LR, r = 0.74; AP, r = 0.72), whereas the 95% LoA (bias ± 1.96 × standard deviation of the setup error differences) were − 1.61 ± 4.29 mm (LR), − 0.41 ± 5.45 mm (SI), and 0.67 ± 4.29 mm (AP), revealing no agreements in all directions. The cumulative frequencies (%) of the cases with absolute setup error differences within 3 mm in each direction were 80.83% (LR), 81.86% (SI), and 90.71% (AP), with all directions having large proportions of > 3-mm differences. The MMI-algorithm-based automatic registration is not compatible with the bone-structure-based manual registration and should not be used alone for prostate cancer.
KeywordsImage registration Maximization of mutual information Cone-beam computed tomography Imaging beam line Image-guided radiation therapy Setup error
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Statement of human/animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRB (approval number 15301, Osaka University Ethics Committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed.
For this retrospective study, passive informed consent (opt-out) was obtained from all individual participants.
- 2.Pouliot J, Bani-Hashemi A, Chen J, Svatos M, Ghelmansarai F, Mitschke M, Aubin M, Xia P, Morin O, Bucci K, Roach M 3rd, Hernandez P, Zheng Z, Hristov D, Verhey L. Low-dose megavoltage cone-beam CT for radiation therapy. Int J Radiat Oncol Biol Phys. 2005;61(2):552–60. https://doi.org/10.1016/j.ijrobp.2004.10.011.CrossRefPubMedGoogle Scholar
- 5.Breitbach EK, Maltz JS, Gangadharan B, Bani-Hashemi A, Anderson CM, Bhatia SK, Stiles J, Edwards DS, Flynn RT. Image quality improvement in megavoltage cone beam CT using an imaging beam line and a sintered pixelated array system. Med Phys. 2011;38(11):5969–79. https://doi.org/10.1118/1.3651470.CrossRefPubMedGoogle Scholar
- 9.Grams MP, Brown LC, Brinkmann DH, Pafundi DH, Mundy DW, Garces YI, Park SS, Olivier KR, de los Santos LE. Analysis of automatic match results for cone-beam computed tomography localization of conventionally fractionated lung tumors. Pract Radiat Oncol. 2014;4(1):35–42. https://doi.org/10.1016/j.prro.2013.02.008.CrossRefPubMedGoogle Scholar
- 12.Shi W, Li JG, Zlotecki RA, Yeung A, Newlin H, Palta J, Liu C, Chvetsov AV, Olivier K. Evaluation of kV cone-beam CT performance for prostate IGRT: a comparison of automatic grey-value alignment to implanted fiducial-marker alignment. Am J Clin Oncol. 2011;34(1):16–21. https://doi.org/10.1097/COC.0b013e3181d26b1a.CrossRefPubMedGoogle Scholar
- 14.Cubillos Mesías M, Boda-Heggemann J, Thoelking J, Lohr F, Wenz F, Wertz H. Quantification and assessment of interfraction setup errors based on cone beam CT and determination of safety margins for radiotherapy. PLoS One. 2016;11(3):e0150326. https://doi.org/10.1371/journal.pone.0150326.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Thilmann C, Nill S, Tücking T, Höss A, Hesse B, Dietrich L, Bendl R, Rhein B, Häring P, Thieke C, Oelfke U, Debus J, Huber P. Correction of patient positioning errors based on in-line cone beam CTs: clinical implementation and first experiences. Radiat Oncol. 2006;1:16. https://doi.org/10.1186/1748-717X-1-16.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Wong JR, Gao Z, Uematsu M, Merrick S, Machernis NP, Chen T, Cheng CW. Interfractional prostate shifts: review of 1870 computed tomography (CT) scans obtained during image-guided radiotherapy using CT-on-rails for the treatment of prostate cancer. Int J Radiat Oncol Biol Phys. 2008;72(5):1396–401. https://doi.org/10.1016/j.ijrobp.2008.03.045.CrossRefPubMedGoogle Scholar
- 21.Qi XS, Wu S, Newman F, Li XA, Hu AY. Evaluation of interfraction patient setup errors for image-guided prostate and head-and-neck radiotherapy using kilovoltage cone beam and megavoltage fan beam computed tomography. J Radiother Pract. 2013;12(4):334–43. https://doi.org/10.1017/S1460396912000337.CrossRefGoogle Scholar
- 22.Mayyas E, Chetty IJ, Chetvertkov M, Wen N, Neicu T, Nurushev T, Ren L, Lu M, Stricker H, Pradhan D, Movsas B, Elshaikh MA. Evaluation of multiple image-based modalities for image-guided radiation therapy (IGRT) of prostate carcinoma: a prospective study. Med Phys. 2013;40(4):041707. https://doi.org/10.1118/1.4794502.CrossRefPubMedGoogle Scholar
- 24.Graf R, Boehmer D, Budach V, Wust P. Interfraction rotation of the prostate as evaluated by kilovoltage X-ray fiducial marker imaging in intensity-modulated radiotherapy of localized prostate cancer. Med Dosim. 2012;37(4):396–400. https://doi.org/10.1016/j.meddos.2012.02.006.CrossRefPubMedGoogle Scholar