Department of Radiation Oncology, UCLA, 200 Medical Plaza, Suite B265, Los Angeles, CA, 90095, USA.
Med Phys. 2017 Aug;44(8):4126-4138. doi: 10.1002/mp.12321. Epub 2017 Jul 17.
A critical step in adaptive radiotherapy (ART) workflow is deformably registering the simulation CT with the daily or weekly volumetric imaging. Quantifying the deformable image registration accuracy under these circumstances is a complex task due to the lack of known ground-truth landmark correspondences between the source data and target data. Generating landmarks manually (using experts) is time-consuming, and limited by image quality and observer variability. While image similarity metrics (ISM) may be used as an alternative approach to quantify the registration error, there is a need to characterize the ISM values by developing a nonlinear cost function and translate them to physical distance measures in order to enable fast, quantitative comparison of registration performance.
In this paper, we present a proof-of-concept methodology for automated quantification of DIR performance. A nonlinear cost function was developed as a combination of ISM values and governed by the following two expectations for an accurate registration: (a) the deformed data obtained from transforming the simulation CT data with the deformation vector field (DVF) should match the target image data with near perfect similarity, and (b) the similarity between the simulation CT and deformed data should match the similarity between the simulation CT and the target image data. A deep neural network (DNN) was developed that translated the cost function values to actual physical distance measure. To train the neural network, patient-specific biomechanical models of the head-and-neck anatomy were employed. The biomechanical model anatomy was systematically deformed to represent changes in patient posture and physiological regression. Volumetric source and target images with known ground-truth deformations vector fields were then generated, representing the daily or weekly imaging data. Annotated data was then fed through a supervised machine learning process, iteratively optimizing a nonlinear model able to predict the target registration error (TRE) for given ISM values. The cost function for sub-volumes enclosing critical radiotherapy structures in the head-and-neck region were computed and compared with the ground truth TRE values.
When examining different combinations of registration parameters for a single DIR, the neural network was able to quantify DIR error to within a single voxel for 95% of the sub-volumes examined. In addition, correlations between the neural network predicted error and the ground-truth TRE for the Planning Target Volume and the parotid contours were consistently observed to be > 0.9. For variations in posture and tumor regression for 10 different patients, patient-specific neural networks predicted the TRE to within a single voxel > 90% on average.
The formulation presented in this paper demonstrates the ability for fast, accurate quantification of registration performance. DNN provided the necessary level of abstraction to estimate a quantified TRE from the ISM expectations described above, when sufficiently trained on annotated data. In addition, biomechanical models facilitated the DNN with the required variations in the patient posture and physiological regression. With further development and validation on clinical patient data, such networks have potential impact in patient and site-specific optimization, and stream-lining clinical registration validation.
自适应放疗(ART)工作流程中的一个关键步骤是将模拟 CT 与每日或每周容积成像进行变形配准。由于源数据和目标数据之间缺乏已知的真实标记对应关系,因此量化这些情况下的变形图像配准准确性是一项复杂的任务。手动生成标记(使用专家)既耗时又受图像质量和观察者变异性的限制。虽然图像相似性度量(ISM)可用于替代方法来量化配准误差,但需要通过开发非线性成本函数并将其转换为物理距离度量来对 ISM 值进行特征化,以便能够快速、定量地比较配准性能。
在本文中,我们提出了一种用于自动量化 DIR 性能的概念验证方法。开发了一个非线性成本函数,作为 ISM 值的组合,并受以下两个对准确配准的期望的控制:(a)从使用变形向量场(DVF)转换模拟 CT 数据获得的变形数据应与目标图像数据具有近乎完美的相似性,并且(b)模拟 CT 和变形数据之间的相似性应与模拟 CT 和目标图像数据之间的相似性匹配。开发了一个深度神经网络(DNN),将成本函数值转换为实际的物理距离度量。为了训练神经网络,使用了头颈部解剖的患者特定生物力学模型。生物力学模型解剖结构被系统地变形以代表患者姿势和生理回归的变化。然后生成具有已知真实变形向量场的源和目标容积图像,代表每日或每周成像数据。然后将带注释的数据通过有监督的机器学习过程进行处理,迭代优化能够预测给定 ISM 值的目标配准误差(TRE)的非线性模型。计算了包含头颈部关键放疗结构的子体积的成本函数,并将其与地面真实 TRE 值进行了比较。
在检查单个 DIR 的不同配准参数组合时,神经网络能够将 DIR 误差量化到子体积的单个体素内,对于检查的 95%的子体积。此外,对于计划靶区和腮腺轮廓,观察到神经网络预测误差与地面真实 TRE 之间的相关性始终大于 0.9。对于 10 名不同患者的姿势和肿瘤回归变化,患者特定的神经网络平均预测 TRE 误差在单个体素内> 90%。
本文提出的公式证明了快速、准确地量化配准性能的能力。DNN 提供了必要的抽象级别,可根据上述 ISM 期望从图像中估计出已量化的 TRE,前提是在经过充分注释的数据上进行训练。此外,生物力学模型为神经网络提供了患者姿势和生理回归变化所需的支持。通过在临床患者数据上进一步开发和验证,此类网络有可能对患者和站点特定的优化以及简化临床配准验证产生影响。