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Dose Mapping Using Image Registration for Reirradiation: A Systematic Review.

Chelmis Muthoni Thiong'o1, Angela Davey1, Ane Appelt2

  • 1Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom.

International Journal of Radiation Oncology, Biology, Physics
|October 13, 2025
PubMed
Summary
This summary is machine-generated.

Accurate dose mapping using image registration (IR) is crucial for reirradiation. This review highlights gaps in current IR methods for reirradiation, emphasizing the need for better evaluation and reporting to improve patient outcomes.

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Area of Science:

  • Radiation Oncology
  • Medical Imaging
  • Radiotherapy Physics

Background:

  • Reirradiation is increasingly common due to improved patient survival.
  • Accurate mapping of previous radiation dose is vital for balancing toxicity and tumor control.
  • Image registration (IR) is used to align past dose distributions with current anatomy, but anatomical changes pose challenges.

Purpose of the Study:

  • To systematically review current image registration (IR) practices for dose mapping in reirradiation.
  • To identify methodological gaps and underrepresented areas in existing research.
  • To propose recommendations for improving the reproducibility and clinical utility of IR in reirradiation.

Main Methods:

  • A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
  • Searched PubMed, Scopus, ScienceDirect, and American Association of Physicists in Medicine (AAPM) conference abstracts.
  • Reviewed 34 articles and 30 abstracts, extracting data on IR approaches and evaluation strategies.

Main Results:

  • Most studies lacked comprehensive evaluation, with only one-third reporting geometric accuracy metrics.
  • Few studies included dosimetric assessments or uncertainty estimation.
  • Multimodal reirradiation, non-external beam techniques, and pediatric populations were underrepresented.

Conclusions:

  • Current image registration (IR) practices for reirradiation dose mapping have significant methodological gaps.
  • Improved reporting of registration methods, geometric, and dosimetric assessments is essential.
  • Recommendations are proposed to enhance reproducibility and clinical utility for safer, evidence-based reirradiation.