Dosimetric comparison of autocontouring techniques for online adaptive proton therapy
OPEN ACCESS
Loading...
Author / Producer
Date
2023-08-11
Publication Type
Journal Article
ETH Bibliography
yes
Citations
Altmetric
OPEN ACCESS
Data
Rights / License
Abstract
Objective. Anatomical and daily set-up uncertainties impede high precision delivery of proton therapy. With online adaptation, the daily plan is reoptimized on an image taken shortly before the treatment, reducing these uncertainties and, hence, allowing a more accurate delivery. This reoptimization requires target and organs-at-risk (OAR) contours on the daily image, which need to be delineated automatically since manual contouring is too slow. Whereas multiple methods for autocontouring exist, none of them are fully accurate, which affects the daily dose. This work aims to quantify the magnitude of this dosimetric effect for four contouring techniques. Approach. Plans reoptimized on automatic contours are compared with plans reoptimized on manual contours. The methods include rigid and deformable registration (DIR), deep-learning based segmentation and patient-specific segmentation. Main results. It was found that independently of the contouring method, the dosimetric influence of using automatic OAR contours is small (<5% prescribed dose in most cases), with DIR yielding the best results. Contrarily, the dosimetric effect of using the automatic target contour was larger (>5% prescribed dose in most cases), indicating that manual verification of that contour remains necessary. However, when compared to non-adaptive therapy, the dose differences caused by automatically contouring the target were small and target coverage was improved, especially for DIR. Significance. The results show that manual adjustment of OARs is rarely necessary and that several autocontouring techniques are directly usable. Contrarily, manual adjustment of the target is important. This allows prioritizing tasks during time-critical online adaptive proton therapy and therefore supports its further clinical implementation.
Permanent link
Publication status
published
External links
Editor
Book title
Journal / series
Volume
68 (17)
Pages / Article No.
175006
Publisher
IOP Publishing
Event
Edition / version
Methods
Software
Geographic location
Date collected
Date created
Subject
contour propagation; Adaptive radiotherapy; Proton therapy; Deformable image registration; Lung cancer; Head and neck cancer