Investigation of the impact of image-guided radiotherapy selection on image registration results and non-coding RNAs for cervical cancer patients.

Image-guided radiotherapy (IGRT) is a crucial technique in cervical cancer treatment, enabling precise targeting of tumor tissues while minimizing radiation exposure to surrounding healthy tissues. Kilovoltage cone-beam computed tomography (KVCBCT) is commonly used for IGRT, allowing for real-time imaging of tumor position and anatomy during treatment sessions. However, the selection of optimal landmarks for image registration in IGRT remains a topic of investigation. This study investigated role of IGRT in cervical cancer treatment by analyzing eight cervical cancer patients treated at University Hospital between April 2019 and April 2021. All patients underwent KVCBCT IGRT treatment, and initial treatment images were analyzed. Landmarks including bone, coccyx, and tumor regions were selected for image registration with reference images using both automatic and manual registration methods. Correlation was also sought with several non-coding RNAs, particularly miR-21 and miR-34a. The registration results of different landmarks were observed and compared to evaluate their accuracy and reliability. The study revealed that there were no statistically significant differences in positional errors between bone and tumor landmarks in three directions. However, statistically significant differences in positional errors were observed in the XY and Z directions compared to the coccyx landmark. The miRNA levels correlated with documented trends in cervical cancer. These findings suggest that selecting bone and tumor landmarks as optimal registration points for image registration can enhance the effectiveness of IGRT in treating cervical cancer. By employing both automatic and manual registration methods and analyzing the differences in registration results among various landmarks, this study provides insights into the role of IGRT in cervical cancer treatment. The results indicate that choosing bone and tumor landmarks as optimal registration points can improve the accuracy and efficacy of IGRT, leading to better treatment outcomes and reduced side effects. These findings offer scientific evidence and practical guidance for the utilization of IGRT in cervical cancer treatment, providing valuable technical support for future clinical practice.