| Zhao Qiang,Wu Xiangyang,Chang Xiaobin,Feng Tao,Yang Di,Qu Ximei,Wang Xuemin,Deng Jia.Feasibility of application of deformable image registration to the dosimetry assessment of fractionated brachytherapy for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2022,42(3):204-209 |
| Feasibility of application of deformable image registration to the dosimetry assessment of fractionated brachytherapy for cervical cancer |
| Received:October 29, 2021 |
| DOI：10.3760/cma.j.cn112271-20211029-00430 |
| KeyWords:Deformable image registration Brachytherapy Cervical cancer |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zhao Qiang | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Wu Xiangyang | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | 13087566100@163.com | | Chang Xiaobin | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Feng Tao | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Yang Di | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Qu Ximei | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Wang Xuemin | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | | | Deng Jia | Department of Radiation Oncology, Shaanxi Provincial Cancer Hospital, Xi'an 710061, China Corresponding Author:Wu Xiangyang, Email:13087566100@163. com | |
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| Abstract:: |
| Objective To study the differences in the cumulative dose between deformable image registration (DIR) and simple dose-volume histogram (DVH) summation in the fractionated brachytherapy of cervical cancer, and to analyze the feasibility of the application of DIR in the dosimetry assessment of targets and organs-at-risk (OARs) in the brachytherapy. Methods A retrospective analysis was conducted for 13 cases with primary cervical cancer treated with four fractions of interstitial brachytherapy guided by CT images. The four CT images of each cases were registered using an intensity-based DIR. Then, the cumulative doses (the D2 cm3, D1 cm3, and D0.1 cm3 of the bladder, rectum, intestine, and colon and the D90for targets) after DIR were calculated and compared to those obtained using simple DVH summation. Afterward, the correlation between the dose difference and dice similarity coefficient (DSC) was analyzed. With the dose difference (the remaining dose of OARs caused by the DIR) as limits, a new plan was made for the latest CT to calculate the dose increase to targets. Results Compared to simple DVH summation, DIR allowed the cumulative doses of the D2 cm3 and D1 cm3 of bladder to be decreased by (2.47±1.92) and (2.82±2.73) Gy, respectively on average (t=-3.65, -2.93, P<0.05), those of the D2 cm3, D1 cm3, and D0.1 cm3 of rectum to be decreased by (2.05±1.61) Gy, (1.51±1.58), and (3.21±2.50) Gy, respectively on average (t=-4.02, -3.02, -4.06, P<0.05), and those of the D2 cm3, D1 cm3, and D0.1 cm3 to be decreased by (1.42±0.99), (1.55±1.28) Gy, and (2.43±1.95) Gy, respectively on average (t=-3.52, -2.96, -3.06, P<0.05). There was no significant statistical difference in the D90 of targets, the D0.1 cm3 of the bladder, and the D2 cm3, D1 cm3, D0.1 cm3 of the colon (P>0.05) between both methods, and there was no distinct correlation between DSC and dose difference (P>0.05). The DIR increased the dose to targets, with a median value of 150 cGy. However, the accuracy of the DIR should be improved. In clinical practice of multiple fractions of brachytherapy for cervical cancer, it's still recommended to adopt the simple dose summation method to assess the doses to targets and OARs. |
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