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

Authors
Yang, D. S.Yoon, W. S.Lee, J. A.Lee, N. K.Lee, S.Kim, C. Y.Yim, H. J.Lee, S. H.Chung, H. H.Cha, S. H.
Issue Date
9월-2014
Publisher
ELSEVIER SCI LTD
Keywords
Hepatocellular carcinoma; Radiotherapy; Image registration; Gross target volume
Citation
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS, v.30, no.6, pp.676 - 681
Indexed
SCIE
SCOPUS
Journal Title
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
Volume
30
Number
6
Start Page
676
End Page
681
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/97529
DOI
10.1016/j.ejmp.2014.05.003
ISSN
1120-1797
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 (V-GTV[CT]) and MRI (V-GTV[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 V-GTV[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 V-GTV[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 V-GTV[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. (C) 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
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