Radiotherapy of Hodgkin and Non-Hodgkin Lymphoma: A Nonrigid Image-Based Registration Method for Automatic Localization of Prechemotherapy Gross Tumor Volume.
OBJECTIVE
To improve the contouring of clinical target volume for the radiotherapy of neck Hodgkin/non-Hodgkin lymphoma by localizing the prechemotherapy gross target volume onto the simulation computed tomography using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography.


METHODS
The gross target volume delineated on prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography images was warped onto simulation computed tomography using deformable image registration. Fifteen patients with neck Hodgkin/non-Hodgkin lymphoma were analyzed. Quality of image registration was measured by computing the Dice similarity coefficient on warped organs at risk. Five radiation oncologists visually scored the localization of automatic gross target volume, ranking it from 1 (wrong) to 5 (excellent). Deformable registration was compared to rigid registration by computing the overlap index between the automatic gross target volume and the planned clinical target volume and quantifying the V95 coverage.


RESULTS
The Dice similarity coefficient was 0.80 ± 0.07 (median ± quartiles). The physicians' survey had a median score equal to 4 (good). By comparing the rigid versus deformable registration, the overlap index increased from a factor of about 4 and the V95 (percentage of volume receiving the 95% of the prescribed dose) went from 0.84 ± 0.38 to 0.99 ± 0.10 (median ± quartiles).


CONCLUSIONS
This study demonstrates the impact of using deformable registration between prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and simulation computed tomography, in order to automatically localize the gross target volume for radiotherapy treatment of patients with Hodgkin/non-Hodgkin lymphoma.
Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy p.zaffino@unicz.it.
P
P
Zaffino
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy.
D
D
Ciardo
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy.
G
G
Piperno
Nuclear Medicine Division, European Institute of Oncology, Milan, Italy.
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LL
Travaini
Medical Physics Unit, European Institute of Oncology, Milano, Italy.
S
S
Comi
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy.
A
A
Ferrari
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy.
D
D
Alterio
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy Department of Health Sciences, Università degli Studi di Milano, Milano, Italy.
B A
BA
Jereczek-Fossa
Department of Radiation Oncology, European Institute of Oncology, Milano, Italy Department of Health Sciences, Università degli Studi di Milano, Milano, Italy Centro Nazionale di Adroterapia Oncologica, Pavia, Italy.
R
R
Orecchia
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy.
G
G
Baroni
Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy.
M F
MF
Spadea
D059248:Chemoradiotherapy; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D047368:Tumor Burden
GTV identification; [18F]FDG-PET/CT radiation planning; deformable registration; neck lymphoma