The effectiveness of gadolinium MRI to improve target delineation for radiotherapy in hepatocellular carcinoma: A comparative study of rigid image registration techniques

Dae-Sik Yang, Won Sup Yoon, J. A. Lee, N. K. Lee, Suk Lee, Chul Yong Kim, Hyung Joon Yim, S. H. Lee, Hwan Hoon Chung, Sang Hoon Cha

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

To achieve consistent target delineation in radiotherapy for hepatocellular carcinoma (HCC), image registration between simulation CT and diagnostic MRI was explored.Twenty patients with advanced HCC were included. The median interval between MRI and CT was 11 days. CT was obtained with shallow free breathing and MRI at exhale phase. On each CT and MRI, the liver and the gross target volume (GTV) were drawn. A rigid image registration was taken according to point information of vascular bifurcation (Method[A]) and pixel information of volume of interest only including the periphery of the liver (Method[B]) and manually drawn liver (Method[C]). In nine cases with an indefinite GTV on CT, a virtual sphere was generated at the epicenter of the GTV. The GTV from CT (VGTV[CT]) and MRI (VGTV[MR]) and the expanded GTV from MRI (V+GTV[MR]) considering geometrical registration error were defined. The underestimation (uncovered V[CT] by V[MR]) and the overestimation (excessive V[MR] by V[CT]) were calculated. Through a paired T-test, the difference between image registration techniques was analyzed.For method[A], the underestimation rates of VGTV[MR] and V+GTV[MR] were 16.4±8.9% and 3.2±3.7%, and the overestimation rates were 16.6±8.7% and 28.4±10.3%, respectively. For VGTV[MR] and V+GTV[MR], the underestimation rates and overestimation rates of method[A] were better than method[C]. The underestimation rates and overestimation rates of the VGTV[MR] were better in method[B] than method[C]. By image registration and additional margin, about 97% of HCC could be covered. Method[A] or method[B] could be recommended according to physician preference.

Original languageEnglish
Pages (from-to)676-681
Number of pages6
JournalPhysica Medica
Volume30
Issue number6
DOIs
Publication statusPublished - 2014

Keywords

  • Gross target volume
  • Hepatocellular carcinoma
  • Image registration
  • Radiotherapy

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)
  • Medicine(all)

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