SU-E-J-62: Estimating Plausible Treatment Course Dose Distributions by Accounting for Registration Uncertainty and Organ Motion

Journal Article · Sun Jun 01 04:00:00 EDT 2014 · Medical Physics

DOI:https://doi.org/10.1118/1.4888114· OSTI ID:22325221

Thor, M; Saleh, Z; Oh, JH; Apte, A; Deasy, J ^[1]; Muren, L ^[2]

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1. Memorial Sloan-Kettering Cancer Centre, NY City, NY (United States)
2. Aarhus University Hospital, Aarhus C (Denmark)

Purpose: Dose accumulation following deformable image registration (DIR) is challenging. In this study, we used a statistical sampling approach, which takes into account both DIR uncertainties and patient-specific organ motion, to study the distribution of possible true dose distributions. Methods: The study included ten patients (six CT scans/patient) treated with radiotherapy for prostate cancer. For each patient, the planned dose was re-calculated on the repeated geometries, following rigid registration based on fiducial markers. The dose re-calculated on the first CT served as our snapshot dose distribution (D1) and the average of the first five repeat scans as our treatment course reference dose distribution (Dref). Patient-specific motion and DIR-uncertainties, at each voxel in CT1, were assessed using a previously developed DIR performance measure, the distance discordance metric (DDM). To sample the distribution of possible true, predicted dose distributions (Dpred), we resampled D1 by perturbing the location of each voxel with the corresponding DDM. The three dose distribution approaches are compared for the rectum and the bladder. Results: The bladder generalized equivalent uniform dose (gEUD) from the averaged Dpred was closer to the gEUDref than to the gEUD1 (difference: 0.6 vs. 1.0 Gy). For both structures, the gEUDpred was higher than the gEUDref, and significantly higher (p≤0.05) for the rectum (average: 50.8 Gy vs. 48.0 Gy). Conclusion: We have shown that the bladder gEUD values resulting from our DIR-uncertainty inclusive dose sampling approach, Dpred, were closer to the gEUD from Dref than the gEUD values from D1. For the rectum, gEUDpred overestimated gEUDref. Theoretically however, gEUDpred values, sampled from DDM uncertainties are more representative of dose uncertainties.

• OSTI ID: 22325221
• Journal Information: Medical Physics, Journal Name: Medical Physics Journal Issue: 6 Vol. 41; ISSN 0094-2405; ISSN MPHYA6
• Country of Publication: United States
• Language: English

Related Subjects

60 APPLIED LIFE SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BLADDER
IMAGES
METRICS
NEOPLASMS
PATIENTS
PERFORMANCE
PROSTATE
RADIATION DOSE DISTRIBUTIONS
RADIOTHERAPY
RECTUM
SAMPLING