Structure-based deformable image registration: Added value for dose accumulation of external beam radiotherapy and brachytherapy in cervical cancer

Laura E. van Heerden, Antonetta C. Houweling, Kees Koedooder, Zdenko van Kesteren, Niek van Wieringen, Coenraad R. N. Rasch, Bradley R. Pieters, Arjan Bel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and purpose Structure-based deformable image registration (DIR) can be used to calculate accumulated brachytherapy (BT) and external-beam radiation therapy (EBRT) dose–volume histogram (DVH) parameters in cervical cancer. Since direct parameter addition does not take dose non-uniformity into account, the added value of DIR over addition methods was investigated for bladder and rectum. Materials and methods For twelve patients (EBRT: 46 Gy, EBRT + BT: D90 85–90 GyEQD2 in equivalent dose in 2 Gy fractions) the EBRT planning CT and BT planning MRI were registered using DIR. Affected lymph nodes, located far from the BT boost region, received an EBRT boost (9.2 Gy) not contributing to the BT boost dose. Cumulative bladder/rectum D2cm3/D1cm3 were calculated and compared to direct addition methods, assuming uniform EBRT doses (UD), or overlapping high dose volumes (OHD). Results Between the three methods, the maximum differences in the cumulative DVH parameters were 3.2 GyEQD2 (bladder) and 3.3 GyEQD2 (rectum). The difference between DIR and UD was <1.8 GyEQD2 for both organs. Conclusions The UD method provides a better estimate of D2cm3/D1cm3 than the OHD method. There is no added value of DIR since differences with direct addition methods are clinically insignificant. EBRT dose distributions can be considered uniform in bladder and rectum for the evaluated dose parameters.
Original languageEnglish
Pages (from-to)319-324
JournalRadiotherapy and Oncology
Volume123
Issue number2
DOIs
Publication statusPublished - 2017
Externally publishedYes

Cite this

van Heerden, Laura E. ; Houweling, Antonetta C. ; Koedooder, Kees ; van Kesteren, Zdenko ; van Wieringen, Niek ; Rasch, Coenraad R. N. ; Pieters, Bradley R. ; Bel, Arjan. / Structure-based deformable image registration: Added value for dose accumulation of external beam radiotherapy and brachytherapy in cervical cancer. In: Radiotherapy and Oncology. 2017 ; Vol. 123, No. 2. pp. 319-324.
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abstract = "Background and purpose Structure-based deformable image registration (DIR) can be used to calculate accumulated brachytherapy (BT) and external-beam radiation therapy (EBRT) dose–volume histogram (DVH) parameters in cervical cancer. Since direct parameter addition does not take dose non-uniformity into account, the added value of DIR over addition methods was investigated for bladder and rectum. Materials and methods For twelve patients (EBRT: 46 Gy, EBRT + BT: D90 85–90 GyEQD2 in equivalent dose in 2 Gy fractions) the EBRT planning CT and BT planning MRI were registered using DIR. Affected lymph nodes, located far from the BT boost region, received an EBRT boost (9.2 Gy) not contributing to the BT boost dose. Cumulative bladder/rectum D2cm3/D1cm3 were calculated and compared to direct addition methods, assuming uniform EBRT doses (UD), or overlapping high dose volumes (OHD). Results Between the three methods, the maximum differences in the cumulative DVH parameters were 3.2 GyEQD2 (bladder) and 3.3 GyEQD2 (rectum). The difference between DIR and UD was <1.8 GyEQD2 for both organs. Conclusions The UD method provides a better estimate of D2cm3/D1cm3 than the OHD method. There is no added value of DIR since differences with direct addition methods are clinically insignificant. EBRT dose distributions can be considered uniform in bladder and rectum for the evaluated dose parameters.",
author = "{van Heerden}, {Laura E.} and Houweling, {Antonetta C.} and Kees Koedooder and {van Kesteren}, Zdenko and {van Wieringen}, Niek and Rasch, {Coenraad R. N.} and Pieters, {Bradley R.} and Arjan Bel",
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Structure-based deformable image registration: Added value for dose accumulation of external beam radiotherapy and brachytherapy in cervical cancer. / van Heerden, Laura E.; Houweling, Antonetta C.; Koedooder, Kees; van Kesteren, Zdenko; van Wieringen, Niek; Rasch, Coenraad R. N.; Pieters, Bradley R.; Bel, Arjan.

In: Radiotherapy and Oncology, Vol. 123, No. 2, 2017, p. 319-324.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Structure-based deformable image registration: Added value for dose accumulation of external beam radiotherapy and brachytherapy in cervical cancer

AU - van Heerden, Laura E.

AU - Houweling, Antonetta C.

AU - Koedooder, Kees

AU - van Kesteren, Zdenko

AU - van Wieringen, Niek

AU - Rasch, Coenraad R. N.

AU - Pieters, Bradley R.

AU - Bel, Arjan

PY - 2017

Y1 - 2017

N2 - Background and purpose Structure-based deformable image registration (DIR) can be used to calculate accumulated brachytherapy (BT) and external-beam radiation therapy (EBRT) dose–volume histogram (DVH) parameters in cervical cancer. Since direct parameter addition does not take dose non-uniformity into account, the added value of DIR over addition methods was investigated for bladder and rectum. Materials and methods For twelve patients (EBRT: 46 Gy, EBRT + BT: D90 85–90 GyEQD2 in equivalent dose in 2 Gy fractions) the EBRT planning CT and BT planning MRI were registered using DIR. Affected lymph nodes, located far from the BT boost region, received an EBRT boost (9.2 Gy) not contributing to the BT boost dose. Cumulative bladder/rectum D2cm3/D1cm3 were calculated and compared to direct addition methods, assuming uniform EBRT doses (UD), or overlapping high dose volumes (OHD). Results Between the three methods, the maximum differences in the cumulative DVH parameters were 3.2 GyEQD2 (bladder) and 3.3 GyEQD2 (rectum). The difference between DIR and UD was <1.8 GyEQD2 for both organs. Conclusions The UD method provides a better estimate of D2cm3/D1cm3 than the OHD method. There is no added value of DIR since differences with direct addition methods are clinically insignificant. EBRT dose distributions can be considered uniform in bladder and rectum for the evaluated dose parameters.

AB - Background and purpose Structure-based deformable image registration (DIR) can be used to calculate accumulated brachytherapy (BT) and external-beam radiation therapy (EBRT) dose–volume histogram (DVH) parameters in cervical cancer. Since direct parameter addition does not take dose non-uniformity into account, the added value of DIR over addition methods was investigated for bladder and rectum. Materials and methods For twelve patients (EBRT: 46 Gy, EBRT + BT: D90 85–90 GyEQD2 in equivalent dose in 2 Gy fractions) the EBRT planning CT and BT planning MRI were registered using DIR. Affected lymph nodes, located far from the BT boost region, received an EBRT boost (9.2 Gy) not contributing to the BT boost dose. Cumulative bladder/rectum D2cm3/D1cm3 were calculated and compared to direct addition methods, assuming uniform EBRT doses (UD), or overlapping high dose volumes (OHD). Results Between the three methods, the maximum differences in the cumulative DVH parameters were 3.2 GyEQD2 (bladder) and 3.3 GyEQD2 (rectum). The difference between DIR and UD was <1.8 GyEQD2 for both organs. Conclusions The UD method provides a better estimate of D2cm3/D1cm3 than the OHD method. There is no added value of DIR since differences with direct addition methods are clinically insignificant. EBRT dose distributions can be considered uniform in bladder and rectum for the evaluated dose parameters.

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