Comparative evaluation of target volumes defined by deformable and rigid registration of diagnostic PET/CT to planning CT in primary esophageal cancer

Background: To evaluate the geometrical differences of target volumes propagated by deformable image registration (DIR) and rigid image registration (RIR) to assist target volume delineation between diagnostic Positron emission tomography/computed tomography (PET/CT) and planning CT for primary esophageal cancer (EC). Methods: Twenty-five patients with EC sequentially underwent a diagnostic 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan and planning CT simulation. Only 19 patients with maximum standardized uptake value (SUVmax) ≥ 2.0 of the primary volume were available. Gross tumor volumes (GTVs) were delineated using CT and PET display settings. The PET/CT images were then registered with planning CT using MIM software. Subsequently, the PET and CT contours were propagated by RIR and DIR to planning CT. The properties of these volumes were compared. Results: When GTVCT delineated on CT of PET/CT after both RIR and DIR was compared with GTV contoured on planning CT, significant improvements using DIR were observed in the volume, displacements of the center of mass (COM) in the 3-dimensional (3D) direction, and Dice similarity coefficient (DSC) (P = 0.003; 0.006; 0.014). Although similar improvements were not observed for the same comparison using DIR for propagated PET contours from diagnostic PET/CT to planning CT (P > 0.05), for DSC and displacements of COM in the 3D direction of PET contours, the DIR resulted in the improved volume of a large percentage of patients (73.7%; 68.45%; 63.2%) compared with RIR. For diagnostic CT-based contours or PET contours at SUV2.5 propagated by DIR with planning CT, the DSC and displacements of COM in 3D directions in the distal segment were significantly improved compared to the upper and middle segments (P > 0.05). Conclusion: We observed a trend that deformable registration might improve the overlap for gross target volumes from diagnostic PET/CT to planning CT. The distal EC might benefit more from DIR.

[1]  Xindong Sun,et al.  PET/CT imaging-guided dose painting in radiation therapy. , 2014, Cancer letters.

[2]  Vladimir Pekar,et al.  Assessment of a model-based deformable image registration approach for radiation therapy planning. , 2007, International journal of radiation oncology, biology, physics.

[3]  S. Senan,et al.  Conventional 3D staging PET/CT in CT simulation for lung cancer: impact of rigid and deformable target volume alignments for radiotherapy treatment planning. , 2011, The British journal of radiology.

[4]  P. Price,et al.  Computed tomography overestimation of esophageal tumor length: Implications for radiotherapy planning. , 2010, World journal of gastrointestinal oncology.

[5]  Nataliya Kovalchuk,et al.  Deformable registration of preoperative PET/CT with postoperative radiation therapy planning CT in head and neck cancer. , 2012, Radiographics : a review publication of the Radiological Society of North America, Inc.

[6]  P. Jarritt,et al.  (18)F-FDG PET-CT simulation for non-small-cell lung cancer: effect in patients already staged by PET-CT. , 2010, International journal of radiation oncology, biology, physics.

[7]  Ping Xia,et al.  Can positron emission tomography (PET) or PET/Computed Tomography (CT) acquired in a nontreatment position be accurately registered to a head-and-neck radiotherapy planning CT? , 2009, International Journal of Radiation Oncology, Biology, Physics.

[8]  T. Pan,et al.  The clinical application of 4D 18F-FDG PET/CT on gross tumor volume delineation for radiotherapy planning in esophageal squamous cell cancer , 2012, Journal of radiation research.

[9]  Jinkoo Kim,et al.  Intrafraction variability and deformation quantification in the breast. , 2015, International journal of radiation oncology, biology, physics.

[10]  Neil Woodhouse,et al.  Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT , 2007, International journal of radiation oncology, biology, physics.

[11]  R. Hicks,et al.  Where do we draw the line? Contouring tumors on positron emission tomography/computed tomography. , 2008, International journal of radiation oncology, biology, physics.

[12]  Ron Kikinis,et al.  Statistical validation of image segmentation quality based on a spatial overlap index. , 2004, Academic radiology.

[13]  J. Sinacore,et al.  Comparison of standardized uptake value-based positron emission tomography and computed tomography target volumes in esophageal cancer patients undergoing radiotherapy. , 2010, International journal of radiation oncology, biology, physics.

[14]  Ellen Yorke,et al.  18F-FDG PET/CT for Image-Guided and Intensity-Modulated Radiotherapy* , 2009, Journal of Nuclear Medicine.

[15]  Nils Lehmann,et al.  Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  J. Palta,et al.  The Effect of Intravenous Contrast on Intensity-Modulated Radiation Therapy Dose Calculations for Head and Neck Cancer , 2005, American journal of clinical oncology.

[17]  J. Piper,et al.  SU‐FF‐I‐68: Evaluation of An Intensity‐Based Free‐Form Deformable Registration Algorithm , 2007 .

[18]  U. Nestle,et al.  FDG-PET-based radiotherapy planning in lung cancer: optimum breathing protocol and patient positioning--an intraindividual comparison. , 2009, International journal of radiation oncology, biology, physics.

[19]  Parminder S Basran,et al.  Deformable versus rigid registration of PET/CT images for radiation treatment planning of head and neck and lung cancer patients: a retrospective dosimetric comparison , 2014, Radiation Oncology.

[20]  David Thwaites,et al.  The evaluation of a deformable image registration segmentation technique for semi-automating internal target volume (ITV) production from 4DCT images of lung stereotactic body radiotherapy (SBRT) patients. , 2011, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[21]  Habib Zaidi,et al.  PET-guided delineation of radiation therapy treatment volumes: a survey of image segmentation techniques , 2010, European Journal of Nuclear Medicine and Molecular Imaging.

[22]  J. Clarke,et al.  Medicine , 1907, Bristol medico-chirurgical journal.

[23]  Cyrill Burger,et al.  PET-CT image co-registration in the thorax: influence of respiration , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[24]  Cindy J. Lai.  Medicine (MEDICINE) , 2017 .