Prospective quantitative quality assurance and deformation estimation of MRI-CT image registration in simulation of head and neck radiotherapy patients

Kendall Kiser; Mohamed A.M. Meheissen; Abdallah S.R. Mohamed; Mona Kamal; Sweet Ping Ng; Hesham Elhalawani; Amit Jethanandani; Renjie He; Yao Ding; Yousri Rostom; Neamat Hegazy; Houda Bahig; Adam Garden; Stephen Lai; Jack Phan; Gary B. Gunn; David Rosenthal; Steven Frank; Kristy K. Brock; Jihong Wang; Clifton D. Fuller

Clinical and Translational Radiation Oncology (Sep 2019)

Prospective quantitative quality assurance and deformation estimation of MRI-CT image registration in simulation of head and neck radiotherapy patients

Kendall Kiser,
Mohamed A.M. Meheissen,
Abdallah S.R. Mohamed,
Mona Kamal,
Sweet Ping Ng,
Hesham Elhalawani,
Amit Jethanandani,
Renjie He,
Yao Ding,
Yousri Rostom,
Neamat Hegazy,
Houda Bahig,
Adam Garden,
Stephen Lai,
Jack Phan,
Gary B. Gunn,
David Rosenthal,
Steven Frank,
Kristy K. Brock,
Jihong Wang,
Clifton D. Fuller

Affiliations

Kendall Kiser: University of Texas, John P. and Kathrine G. McGovern Medical School, 6431 Fannin Street, Houston, TX 77030, USA; UT Health School of Biomedical Informatics, 7000 Fannin Street, Suite 600, Houston, TX 77030, USA; Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Mohamed A.M. Meheissen: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
Abdallah S.R. Mohamed: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt; MD Anderson Cancer Center/UT Health Graduate School of Biomedical Sciences, 6767 Bertner Avenue, Houston, TX 77030, USA
Mona Kamal: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Ain Shams, Lofty El-Said Street, 1156 Cairo, Egypt
Sweet Ping Ng: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Radiation Oncolog, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia
Hesham Elhalawani: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Amit Jethanandani: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; College of Medicine, University of Tennessee Health Science Center, 910 Madison Avenue #1002, Memphis, TN 38103, USA
Renjie He: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Yao Ding: Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Yousri Rostom: Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
Neamat Hegazy: Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, 17 Champilion Street, Alazarita, Alexandria, Egypt
Houda Bahig: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Radiation Oncology, Centre Hospitalier de l’Universite de Montreal, 1051 Rue Sanguinet, Montreal, QC H2X 3E4, Canada
Adam Garden: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Stephen Lai: Department of Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
Jack Phan: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Gary B. Gunn: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
David Rosenthal: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Steven Frank: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Kristy K. Brock: Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Imaging Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Jihong Wang: Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
Clifton D. Fuller: Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, The MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Corresponding author.

Journal volume & issue: Vol. 18
pp. 120 – 127

Abstract

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Background: MRI-guided radiotherapy planning (MRIgRT) may be superior to CT-guided planning in some instances owing to its improved soft tissue contrast. However, MR images do not communicate tissue electron density information necessary for dose calculation and therefore must either be co-registered to CT or algorithmically converted to synthetic CT. No robust quality assessment of commercially available MR-CT registration algorithms is yet available; thus we sought to quantify MR-CT registration formally. Methods: Head and neck non-contrast CT and T2 MRI scans acquired with standard treatment immobilization techniques were prospectively acquired from 15 patients. Per scan, 35 anatomic regions of interest (ROIs) were manually segmented. MRIs were registered to CT rigidly (RIR) and by three commercially available deformable registration algorithms (DIR). Dice similarity coefficient (DSC), Hausdorff distance mean (HD mean) and Hausdorff distance max (HD max) metrics were calculated to assess concordance between MRI and CT segmentations. Each DIR algorithm was compared to DIR using the nonparametric Steel test with control for individual ROIs (n = 105 tests) and for all ROIs in aggregate (n = 3 tests). The influence of tissue type on registration fidelity was assessed using nonparametric Wilcoxon pairwise tests between ROIs grouped by tissue type (n = 12 tests). Bonferroni corrections were applied for multiple comparisons. Results: No DIR algorithm improved the segmentation quality over RIR for any ROI nor all ROIs in aggregate (all p values >0.05). Muscle and gland ROIs were significantly more concordant than vessel and bone, but DIR remained non-different from RIR. Conclusions: For MR-CT co-registration, our results question the utility and applicability of commercially available DIR over RIR alone. The poor overall performance also questions the feasibility of translating tissue electron density information to MRI by CT registration, rather than addressing this need with synthetic CT generation or bulk-density assignment. Keywords: MRI-guided radiotherapy, CT-MRI image registration, Deformable image registration, Rigid image registration, Quality assessment

Published in Clinical and Translational Radiation Oncology

ISSN: 2405-6308 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/clinical-and-translational-radiation-oncology

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