Review and recommendations on deformable image registration uncertainties for radiotherapy applications
Lena Nenoff1,2,3,4, Florian Amstutz5,6,7, Martina Murr8
1Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States of America.
Physics in Medicine and Biology
|November 16, 2023
Summary
Deformable image registration (DIR) in radiotherapy has geometric uncertainties that hinder clinical use. This review addresses DIR uncertainties and provides recommendations for safer, more reliable applications in radiation therapy.
Area of Science:
- Medical Physics
- Radiotherapy
- Medical Imaging
Background:
- Deformable image registration (DIR) is widely used in radiotherapy (RT).
- DIR algorithms are integrated into commercial treatment planning systems.
- Significant geometric uncertainty in DIR poses challenges for clinical adoption.
Purpose of the Study:
- To review the literature on sources of DIR uncertainties in RT.
- To analyze the impact of DIR uncertainties on RT applications.
- To provide recommendations for managing DIR uncertainties.
Main Methods:
- Literature review of deformable image registration uncertainties in radiotherapy.
- Analysis of current practices and challenges in quantifying DIR uncertainties.
- Synthesis of recommendations for clinical use, commissioning, research, and development.
Main Results:
- Geometric uncertainty in DIR is substantial and difficult to quantify.
- Lack of community consensus on quantifying DIR uncertainty and setting quality thresholds.
- Identified sources of DIR uncertainty and their impact across various RT applications.
Conclusions:
- Standardized methods for quantifying DIR uncertainty are needed.
- Clearer guidelines are required for clinical implementation and quality assurance.
- Recommendations are provided for researchers, clinicians, and vendors to improve DIR reliability in RT.
