Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) · 2025
Assessment of the use of synthetic CT produced by deformable image registration of planning CT and CBCT in adaptive radiotherapy treatments of head and neck cancers.
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Sanju Sanju, Mukherji Ashutosh, Nanda Sambit S, Dokania Shubham, Kataria Alka, Kumar Narender, Saini Vinay, Barman Sanjay, Epili Dandpani R, Choubey Ajay, Patil Ninad H, Krishnan Ajay
Аннотация
INTRODUCTION: The present study uses deformable image registration to produce synthetic CT (sCT) images and investigate their use in treatment planning and improving clinical judgment in assessing the need for adaptive radiotherapy (ART).
METHODS: A total of 30 patients with squamous cell carcinoma of the head and neck (HNSCC) who underwent ART were included in this study. The patients considered for adaptive planning, were re-simulated within 1-2 days. Both the Day 1 planning CT (pCT) and acquired CBCT were imported in Velocity® and a new sCT was created. The new treatment plan on re-simulation CT (rCT) which was planned for treatment delivery was recalculated on sCT. The geometric differences (Volume, Dice Similarity coefficient (DSC), mean distance to agreement (MDA)) in structures and dosimetric differences (Gamma analysis, mean doses and other DVH parameters) in treatment plans between the two images (sCT and rCT) were compared.
RESULTS: The evaluation between sCT and rCT revealed that the average DSC and MDA for all the structures obtained was 0.86(0.05) and 1.15(0.20) respectively. Global gamma passing rate for 3 %, 3 mm was 96.85 ± 2.10 %. Mean dose for OARs and PTVs were found to be similar (difference within 3 %) in the two images.
CONCLUSION: sCT can be used to predict the per fraction dose delivered to the patient and could be a better alternative than only relying on clinical judgments, to take the patient for ART. Further work needs to be done on the use of sCT images to replace rCT images for ART.
METHODS: A total of 30 patients with squamous cell carcinoma of the head and neck (HNSCC) who underwent ART were included in this study. The patients considered for adaptive planning, were re-simulated within 1-2 days. Both the Day 1 planning CT (pCT) and acquired CBCT were imported in Velocity® and a new sCT was created. The new treatment plan on re-simulation CT (rCT) which was planned for treatment delivery was recalculated on sCT. The geometric differences (Volume, Dice Similarity coefficient (DSC), mean distance to agreement (MDA)) in structures and dosimetric differences (Gamma analysis, mean doses and other DVH parameters) in treatment plans between the two images (sCT and rCT) were compared.
RESULTS: The evaluation between sCT and rCT revealed that the average DSC and MDA for all the structures obtained was 0.86(0.05) and 1.15(0.20) respectively. Global gamma passing rate for 3 %, 3 mm was 96.85 ± 2.10 %. Mean dose for OARs and PTVs were found to be similar (difference within 3 %) in the two images.
CONCLUSION: sCT can be used to predict the per fraction dose delivered to the patient and could be a better alternative than only relying on clinical judgments, to take the patient for ART. Further work needs to be done on the use of sCT images to replace rCT images for ART.