title: Tumour delineation and cumulative dose computation in radiotherapy based on deformable registration of respiratory correlated CT images of lung cancer patients.
abstract: OBJECTIVE
  To improve treatment planning in radiotherapy for non-small cell lung cancer by including Respiratory Correlated-Computed Tomography (RC-CT) information in tumour delineation and dose planning.
  
  
  METHODS
  Dense displacement fields were computed using a combination of rigid and non-rigid registrations between RC-CT phases. These registrations have been performed independently between each phase of the respiratory cycle and a reference phase for 13 patients. A manual delineation in the reference frame was propagated to every other phase according to the deformation fields recovered from the inter-phase registrations. Resulting delineations were compared to two manual delineations drawn by two physicians at each phase. On the other hand, dose distributions computed for every phase were deformed towards the reference phase. These distributions were then added on the reference phase to estimate the total dose received by each voxel through the whole respiratory cycle.
  
  
  RESULTS
  The overlap between the deformed and the manual delineations was not significantly different than the overlap between the delineations made by the two physicians for 11 out of 13 patients thus proving that the method accuracy is comparable to inter-observer variability. Calculation of the effective dose distributions showed that these were conserved after deformation.
  
  
  CONCLUSIONS
  We developed a method to use RC-CT information into the radiation treatment planning, including semi-automatic segmentation of lung tumours on each phase of the respiratory cycle and a total received dose per voxel estimation.
authors.affiliation: Communications and Remote Sensing Laboratory (TELE), Université catholique de Louvain, Louvain-la-Neuve, Belgium. jonathan.orban@uclouvain.be
authors.forename: Jonathan
authors.initials: J
authors.lastname: Orban de Xivry
authors.forename: Guillaume
authors.initials: G
authors.lastname: Janssens
authors.forename: Geert
authors.initials: G
authors.lastname: Bosmans
authors.forename: Mathieu
authors.initials: M
authors.lastname: De Craene
authors.forename: André
authors.initials: A
authors.lastname: Dekker
authors.forename: Jeroen
authors.initials: J
authors.lastname: Buijsen
authors.forename: Angela
authors.initials: A
authors.lastname: van Baardwijk
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Benoit
authors.initials: B
authors.lastname: Macq
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D015588:Observer Variation; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012119:Respiration; D014057:Tomography, X-Ray Computed / Q000379:methods*