Rigid and Deformable Image Registration for Radiation Therapy: A Self-Study Evaluation Guide in YYYY Clinical Trial Participation.

Abstract

The registration of multiple imaging studies to radiation therapy CT simulation, including MRI, PET-CT, and SPECT is a widely used strategy in Radiation Oncology treatment planning, and these registrations have valuable roles in image guidance, dose composition, and treatment delivery adaptation. TG132 AAPM report on the use of image registration and fusion algorithms in radiotherapy provides basic guidelines for quality assurance and quality control of the image registration algorithms, and the overall clinical process. The report recommends a series of tests and the corresponding metrics that should be evaluated and reported during commissioning and routine quality assurance, as well as a set of recommendations for vendors. The YYYY medical physics subcommittee formed a working group to investigate the feasibility of clinical implementation of TG132 and found incompatibility of some digital phantoms with commercial systems. Thus there is still a need in providing further recommendations in terms of compatible digital phantoms, clinical feasible workflow, and achievable thresholds, especially for future clinical trials involving deformable image registration (DIR) algorithms. Nine institutions participated and evaluated four commonly used commercial imaging registration software and various versions in the field of radiation oncology. The work group focused on providing a methodology to evaluate the image registration performance, a workflow for self-study evaluation of image registration, and recommendations for future YYYY Oncology clinical trials that involve image registration, dose accumulation, and adaptive radiotherapy. The YYYY Oncology Working Group on DIR herein provides complimentary digital phantom/datasets and analytical software access for institutions and clinics to perform their own self-study evaluation of commercial imaging systems that might be employed for co-registration in radiation therapy treatment planning and image guidance procedures.