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Validation of image registration and fusion of MV CBCT and planning CT for radiotherapy treatment planning

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Abstract

In areas like adaptive therapy, multi-phase radiotherapy, and single fraction palliative treatment or in the treatment of patients with metal implants where megavoltage(MV) CT could be considered as a treatment planning modality, the reduced contrast in the MV CT images could lead to limited accuracy in localization of the structures. This would affect the precision of the treatment. In this study, as an extension our previous work on bespoke MV cone beam CT (MV CBCT), we propose to register the MV CBCT with kilovoltage (kV) CT for treatment planning. The MV CBCT images registered with kV CT would be effective for treatment planning as it would account for the inadequate soft tissue information in the MV CBCT and would allow comparison of changes in patient dimensions and assist in localization of the structures. The intensity based registration algorithm of the BrainSCAN therapy planning software was used for image registration of the MV CBCT and kV CT images. The accuracy of the registration was validated using qualitative and quantitative measures. The effect of image quality on the level of agreement between the contouring done on both the MV CBCT and kV CT was assessed by comparing the volumes of six structures delineated. To assess the level of agreement between the plans after the registration, two independent plans were generated on the MV CBCT and the planning CT using the posterior fossa of the skull as the target. The dose volume histograms and conformity indices of the plans were compared. The results of this study show that treatment planning with MV CBCT images would be effective, using additional anatomical structure information derived from registering the MV CBCT image with a standard kVCT.

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Abbreviations

CT:

Computed tomography

MV CBCT:

Megavoltage cone beam CT

MV CT:

Megavoltage computed Tomography

kV CT:

Kilovoltage computed tomography

kV CBCT:

Kilovoltage cone beam computed tomography

EPID:

Electronic portal imaging device

HU:

Hounsfield units

TPS:

Treatment planning system

DVH:

Dose volume histogram

CI:

Conformity index

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Authors and Affiliations

  1. Department of Bioengineering, Christian Medical College, Vellore, India

    T. Hannah Mary Thomas

  2. Department of Nuclear Medicine, Christian Medical College, Vellore, India

    D. Devakumar

  3. Department of Radiotherapy, Christian Medical College, Vellore, India

    S. Balukrishna, Henry Finlay Godson & B. Paul Ravindran

Authors
  1. T. Hannah Mary Thomas
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  2. D. Devakumar
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  3. S. Balukrishna
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  4. Henry Finlay Godson
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  5. B. Paul Ravindran
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Correspondence to T. Hannah Mary Thomas.

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Thomas, T.H.M., Devakumar, D., Balukrishna, S. et al. Validation of image registration and fusion of MV CBCT and planning CT for radiotherapy treatment planning. Australas Phys Eng Sci Med 34, 441–447 (2011). https://doi.org/10.1007/s13246-011-0092-2

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  • DOI: https://doi.org/10.1007/s13246-011-0092-2

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