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Title: Dosimetric Evaluation of Automatic Segmentation for Adaptive IMRT for Head-and-Neck Cancer

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
;  [1];  [2]; ;  [1]
  1. Department of Radiation Oncology, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (United States)
  2. Biostatistics Core, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (United States)

Purpose: Adaptive planning to accommodate anatomic changes during treatment requires repeat segmentation. This study uses dosimetric endpoints to assess automatically deformed contours. Methods and Materials: Sixteen patients with head-and-neck cancer had adaptive plans because of anatomic change during radiotherapy. Contours from the initial planning computed tomography (CT) were deformed to the mid-treatment CT using an intensity-based free-form registration algorithm then compared with the manually drawn contours for the same CT using the Dice similarity coefficient and an overlap index. The automatic contours were used to create new adaptive plans. The original and automatic adaptive plans were compared based on dosimetric outcomes of the manual contours and on plan conformality. Results: Volumes from the manual and automatic segmentation were similar; only the gross tumor volume (GTV) was significantly different. Automatic plans achieved lower mean coverage for the GTV: V95: 98.6 {+-} 1.9% vs. 89.9 {+-} 10.1% (p = 0.004) and clinical target volume: V95: 98.4 {+-} 0.8% vs. 89.8 {+-} 6.2% (p < 0.001) and a higher mean maximum dose to 1 cm{sup 3} of the spinal cord 39.9 {+-} 3.7 Gy vs. 42.8 {+-} 5.4 Gy (p = 0.034), but no difference for the remaining structures. Conclusions: Automatic segmentation is not robust enough to substitute for physician-drawn volumes, particularly for the GTV. However, it generates normal structure contours of sufficient accuracy when assessed by dosimetric end points.

OSTI ID:
21436027
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.06.012; PII: S0360-3016 (09)00922-5; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
Country of Publication:
United States
Language:
English