Quantitative assessment of dose accumulation uncertainty using a commercial deformable image registration algorithm in adaptive intensity-modulated proton therapy for prostate cancer

•The impact of DIR error on prostate proton dose accumulation was evaluated.•A well-regularized DIR algorithm was used as a reference.•The geometric and dosimetric DIR error was assessed on a structure-basis.•Dose variation due to anatomical change exceeded the DIR uncertainties.•The structure-guide...

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Vydáno v:Physica medica Ročník 135; s. 105011
Hlavní autoři: Xu, Yihang, Ford, John Chetley, Padgett, Kyle R., Dogan, Nesrin
Médium: Journal Article
Jazyk:angličtina
Vydáno: Italy Elsevier Ltd 01.07.2025
Témata:
Adaptive IMPT
Algorithms
Dose accumulation uncertainty
Humans
Image Processing, Computer-Assisted - methods
Male
Prostate cancer
Prostatic Neoplasms - diagnostic imaging
Prostatic Neoplasms - radiotherapy
Proton Therapy
Radiation Dosage
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Intensity-Modulated - methods
Tomography, X-Ray Computed
Uncertainty
OAR
ART
IMRT
CTV
prCT
GTV
IMPT
Dose accumulation uncertainty
SD
RBE
SICLE
MFO
Accum_ref
Adaptive IMPT
pCT
rCT
Doseref
DMP
Dosetest
ICE
DIR
ROI
SGD
Accum_DMP
RE
Accum_DMP+SGD
DVF
DVFref
Prostate cancer
DVFtest
ISSN:1120-1797, 1724-191X, 1724-191X
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Shrnutí:•The impact of DIR error on prostate proton dose accumulation was evaluated.•A well-regularized DIR algorithm was used as a reference.•The geometric and dosimetric DIR error was assessed on a structure-basis.•Dose variation due to anatomical change exceeded the DIR uncertainties.•The structure-guided DIR was found to reduce dose accumulation uncertainty. This work aims to quantify the dose accumulation uncertainty for prostate adaptive intensity modulated proton therapy (IMPT). Pelvic CT images from ten prostate patients with 6 repeat CT (rCT) scans were selected. The reference DVFs (DVFref) were generated by performing DIR between planning CT (pCT) and rCTs using a reference DIR algorithm. Pseudo-rCTs were created by deforming pCT to rCTs using the DVFref. An IMPT plan was created for each patient on pCT, which was recalculated on each pseudo-rCT. The fractional dose was warped back to pCT using DVF (DVFtest) generated by a commercial DIR algorithm which uses a ‘deformable multi pass (DMP)’ algorithm or ‘structure-guided deformable (SGD)’ if DMP failed. The DVFtest deformed dose was compared to the DVFref deformed dose. Registration error (RE) and inverse consistency error (ICE) were assessed for DVFtest. When using only DMP, the RE throughout the whole body was 1.17 ± 1.22 mm. Overall, the ICE for all voxels was 0.18 ± 0.5 mm. The dose deformation uncertainty was 0.02 % ± 2.53 % over the whole body, with the highest uncertainty observed in the bladder (0.83 % ± 6.66 %) and high dose gradient regions. When incorporating SGD, the dose deformation uncertainty inside the CTV was changed from 0.11 % ± 2.42 % to 0.15 % ± 1.4 %, and the uncertainty range of dose accumulation for CTV V100 was reduced from (−3.39 %, 5.49 %) to (−0.31 %, 3.43 %). This study demonstrated that a commercial DIR algorithm is well-suited for prostate IMPT dose accumulation with acceptable geometric and dosimetric uncertainty. The incorporation of SGD has the potential to reduce the uncertainty.
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SourceType-Scholarly Journals-1
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content type line 23
ISSN:1120-1797
1724-191X
1724-191X
DOI:10.1016/j.ejmp.2025.105011