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Deformable image registration for radiation therapy: principle, methods, applications and evaluation.

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Deformable image registration (DIR) is vital in radiation therapy (RT) for anatomical accuracy and dose calculation. While DIR simplifies contouring, complex applications require careful evaluation of its accuracy and uncertainties.

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Area of Science:

  • Medical Physics
  • Radiology
  • Oncology

Background:

  • Deformable image registration (DIR) is crucial for addressing anatomical changes in radiation therapy (RT).
  • This review details DIR's applications and evaluation methods in RT.

Purpose of the Study:

  • To outline the primary uses of DIR in radiation therapy.
  • To discuss current methodologies for evaluating DIR performance.

Main Methods:

  • A systematic literature search was conducted on PubMed and Science Direct for DIR in RT.
  • 207 relevant articles published between January 2000 and October 2018 were selected.

Main Results:

  • DIR applications span RT planning (organ delineation, PTV definition, MRI-based dose calculation) and image-guided RT (contour propagation, dose accumulation).
  • DIR aids in re-irradiation dose estimation and toxicity prediction, but evaluation, especially for complex cases, remains challenging.
  • Geometry-based metrics are common for quantifying DIR uncertainties, though not always sufficient.

Conclusions:

  • DIR is increasingly integral to RT, from planning to toxicity prediction, streamlining contour propagation.
  • Routine use of DIR is established for contour propagation, but complex dosimetric applications demand rigorous quantitative and qualitative assessment.