Author(s)

Masao Tanooka^1*, Hiroshi Doi², Toshihisa Ishida¹, Kazuhiro Kitajima², Tsukasa Wakayama¹, Toshiyuki Sakai¹, Hiroyuki Inoue¹, Noriko Kotoura¹, Kengo Kosaka², Kazuo Tarutani², Masayuki Fujiwara², Norihiko Kamikonya²

¹Department of Radiological Technology, Hyogo College of Medicine College Hospital, Nishinomiya, Japan.
²Department of Radiology, Hyogo College of Medicine, Hyogo, Nishinomiya, Japan.

Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal timing of replanning. A total of 22 patients who underwent volume modulated arc therapy (VMAT) for head and neck (H&N) cancers were prospectively analyzed. The planning target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second planning CT scan (rescan) was performed at the 15th fraction. The DSC was calculated for each structure on both CT scans. The continuous variables to predict the need for replanning were assessed. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. In the correlation between body weight loss and DSC of each structure, weight loss correlated negatively with DSC of the whole face (r_s = -0.45) and the face surface (r_s = -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 face surface required replanning at a significantly high rate (P < 0.05 and P < 0.01). Weight loss correlated with DSC in both the whole face and the face surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the need for replanning. In addition, weight loss tended to correlate with DSC. DIR during ART was found to be a useful tool for replanning.

Deformable Image Registration, Adaptive Radiotherapy, Head and Neck Can-cer, Dice Similarity Coefficient, Volume Modulated Arc Therapy

Tanooka, M. , Doi, H. , Ishida, T. , Kitajima, K. , Wakayama, T. , Sakai, T. , Inoue, H. , Kotoura, N. , Kosaka, K. , Tarutani, K. , Fujiwara, M. and Kamikonya, N. (2017) Usability of Deformable Image Registration for Adaptive Radiotherapy in Head and Neck Cancer and an Automatic Prediction of Replanning. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 6, 10-20. doi: 10.4236/ijmpcero.2017.61002.