Radiation therapy (RT) technological advances call for a comprehensive reconsideration of the definition of dose features leading to radiation induced morbidity (RIM). In this context, the voxel-based approach (VBA) to dose distribution analysis in RT offers a radically new philosophy to evaluate local dose response patterns, as an alternative to dose-volume-histograms for identifying dose sensitive regions of normal tissue. The VBA relies on mapping patient dose distributions into a single reference case anatomy which serves as anchor for local dosimetric evaluations. The inter-patient elastic image registrations (EIRs) of the planning CTs provide the deformation fields necessary for the actual warp of dose distributions. In this study we assessed the impact of EIR on the VBA results in thoracic patients by identifying two state-of-the-art EIR algorithms (Demons and B-Spline). Our analysis demonstrated that both the EIR algorithms may be successfully used to highlight subregions with dose differences associated with RIM that substantially overlap. Furthermore, the inclusion for the first time of covariates within a dosimetric statistical model that faces the multiple comparison problem expands the potential of VBA, thus paving the way to a reliable voxel-based analysis of RIM in datasets with strong correlation of the outcome with non-dosimetric variables.

Inter-patient image registration algorithms to disentangle regional dose bioeffects / Monti, Serena; Pacelli, Roberto; Cella, Laura; Palma, Giuseppe. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 8:1(2018), p. 4915. [10.1038/s41598-018-23327-0]

Inter-patient image registration algorithms to disentangle regional dose bioeffects

Pacelli, Roberto
Membro del Collaboration Group
;
Cella, Laura
Membro del Collaboration Group
;
2018

Abstract

Radiation therapy (RT) technological advances call for a comprehensive reconsideration of the definition of dose features leading to radiation induced morbidity (RIM). In this context, the voxel-based approach (VBA) to dose distribution analysis in RT offers a radically new philosophy to evaluate local dose response patterns, as an alternative to dose-volume-histograms for identifying dose sensitive regions of normal tissue. The VBA relies on mapping patient dose distributions into a single reference case anatomy which serves as anchor for local dosimetric evaluations. The inter-patient elastic image registrations (EIRs) of the planning CTs provide the deformation fields necessary for the actual warp of dose distributions. In this study we assessed the impact of EIR on the VBA results in thoracic patients by identifying two state-of-the-art EIR algorithms (Demons and B-Spline). Our analysis demonstrated that both the EIR algorithms may be successfully used to highlight subregions with dose differences associated with RIM that substantially overlap. Furthermore, the inclusion for the first time of covariates within a dosimetric statistical model that faces the multiple comparison problem expands the potential of VBA, thus paving the way to a reliable voxel-based analysis of RIM in datasets with strong correlation of the outcome with non-dosimetric variables.
2018
Inter-patient image registration algorithms to disentangle regional dose bioeffects / Monti, Serena; Pacelli, Roberto; Cella, Laura; Palma, Giuseppe. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 8:1(2018), p. 4915. [10.1038/s41598-018-23327-0]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/732495
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