Accuracy of contour propagation from planning computed tomography to iterative cone-beam computed tomography using a deformable image registration algorithm for assisting head and neck radiotherapy

• Published in: Physica medica Vol. 133; p. 104972
• Main Authors: Washio, Hayate, Murata, Seiya, Ueda, Yoshihiro, Yamane, Yasuhiko, Konishi, Koji
• Format: Journal Article
• Language: English
• Published: Italy Elsevier Ltd 01.05.2025
• Subjects: Adaptive radiation therapy; Aged; Algorithms; Cone-Beam Computed Tomography; Contour propagation; Deformable image registration; Female; Head and neck cancer; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - radiotherapy; Humans; Image Processing, Computer-Assisted - methods; Iterative cone-beam computed tomography; Male; Middle Aged; Organs at Risk - radiation effects; Radiotherapy Planning, Computer-Assisted - methods; Head and neck cancer; Iterative cone-beam computed tomography; Contour propagation; Deformable image registration; Adaptive radiation therapy
• ISSN: 1120-1797; 1724-191X; 1724-191X
• DOI: 10.1016/j.ejmp.2025.104972

•The deformable image registration technique was used for contour propagation.•Contour propagation from planning to iterative cone-beam CT was effective.•The overall Dice similarity coefficient was >0.8.•The mean distance to agreement was <1.5 mm.•This method enables improved accuracy in adaptive radiotherapy for head and neck. The deteriorated image quality of cone-beam computed tomography (CBCT) reduces the accuracy of contour propagation. We investigated the accuracy of contour propagation from planning CT (pCT) to iterative CBCT (iCBCT) using deformable image registration and compared it with that of replanning CT (reCT) and Feldkamp–Davis–Kress algorithm-based CBCT (FDK-CBCT). No report exists regarding iCBCT improving the accuracy of this technique for images of the head and neck region. We included 29 patients who underwent radiotherapy for head and neck cancer. ReCT and CBCT were performed on the same day. The gross tumor volume (GTV) and organs at risk, including the brain stem, spinal cord, mandible, parotid glands, submandibular glands, and larynx, were manually contoured by radiation oncologists on pCT and reCT images. Contour propagation was performed using MIM software. Manually delineated contours on reCT images and deformably generated contours on reCT, FDK-CBCT, and iCBCT images were compared to determine the accuracy of contour propagation using the Dice similarity coefficient (DSC), mean distance to agreement (MDA), and Hausdorff distance (HD). The mean DSC values for all contoured organs were 0.84 across reCT, FDK-CBCT and iCBCT. A mean DSC value of >0.8 was observed for all organs, except for the larynx and the GTV. The MDA was <1.5 mm for all organs and images, whereas the HD value showed a variation of >3 mm. The results demonstrated no statistically significant difference in contour propagation from pCT to iCBCT compared to pCT to reCT.