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Usability of Deformable Image Registration for Adaptive Radiotherapy in Head and Neck Cancer and an Automatic Prediction of Replanning

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Document pages: 12 pages

Abstract: Deformableimage registration (DIR) has been an important component in adaptiveradiotherapy (ART). Our goal was to examine the accuracy of ART using the dicesimilarity coefficient (DSC) and to determine the optimal timing of replanning.A total of 22 patients who underwent volume modulated arc therapy (VMAT) forhead and neck (H&N) cancers were prospectively analyzed. The planningtarget volume (PTV) was to receive a total of 70 Gy in 33 fractions. A secondplanning CT scan (rescan) was performed at the 15th fraction. The DSC wascalculated for each structure on both CT scans. The continuous variables topredict the need for replanning were assessed. The optimal cut-off value wasdetermined using receiver operating characteristic (ROC) curve analysis. In thecorrelation between body weight loss and DSC of each structure, weight losscorrelated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51).Patients who required replanning tended to have experienced rapid weight loss.The threshold DSC was 0.98 and 0.60 in the whole face and the face surface,respectively. Patients who showed low DSC in the whole face and the facesurface required replanning at a significantly high rate (P

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