Free-to-use DIR solutions in radiotherapy: Benchmark against commercial platforms through a contour-propagation study

A contour propagation study has been conducted to benchmark three algorithms for Deformable Image Registration (DIR) freely available online against well-established commercial solutions.

ElastiX, BRAINS and Plastimach, available as modules in the open source platform 3DSlicer, were tested as the recent AAPM Task group 132 guidelines proposes. The overlap of the DIR-mapped ROIs in four computational anthropomorphic phantoms was measured. To avoid bias every algorithm was left to run without any human interaction nor particular registration strategy. The accuracy of the algorithms was measured using the Dice Similarity Coefficient (DSC) and Mean Distance to Conformity (MDC) metrics. The registration quality was compared to the recommended geometrical accuracy suggested by AAPM TG132 and to the results of a large population-based study performed with commercial DIR solutions.

The considered free-to-use DIR solutions generally meet acceptable accuracy and good overlap (DSC > 0.85). Mild failures (DSC < 0.75) were detected only for the smallest structures. In case of extremely severe deformations acceptable accuracy was not met (MDC > 3 mm). The morphing capability of the tested algorithms equals those of commercial systems when the user interaction is avoided. Underperformances were detected only in cases where a specific registration strategy is mandatory to obtain a satisfying match.

All of the considered algorithms show performances not inferior to previously published data and have the potential to be good candidates for use in the clinical routine. The results and conclusions only apply to the considered phantoms and should not be considered to be generally applicable and extendable to patient cases.