Zhou Dongdong, Shao Yuheng, Wan Fuying, Chen Jiayi, Zhang Yumeng, Feng Jiaqi, Ye Yunfei, Zhou Jinglan, Zeng Fubin, Chen Qi, Wang Shaobin, Lu Heqing, Yang Liang
Department of Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Nantong University Xinglin College, Nantong, China.
J Appl Clin Med Phys. 2025 Jul;26(7):e70135. doi: 10.1002/acm2.70135.
Based on the combination mode of internal and external radiotherapy for cervical cancer, this study aimed to investigate an accurate transformer-based deformable image registration (DIR) method for cumulative dose assessment.
According to a retrospective analysis conducted on 180 patients with cervical cancer who underwent intracavitary brachytherapy (ICBT) and external beam radiation therapy (EBRT), this study proposed a mix-transformer structure-based deformable image registration (MTDIR) network for registering CT scans of ICBT and EBRT, followed by dose accumulation and assessment. The mean dice similarity coefficient (DSC) and Hausdorff distance (HD) of the rectum and bladder were computed to compare the performance of MTDIR with that of the state-of-the-art VoxelMorph method and the DIR method provided by velocity. Additionally, the cumulative dose of the bladder and rectum from four methods was calculated: direct DVH parameter addition (DA), DIR-based dose addition provided by Velocity (VA), VoxelMorph-based dose addition (VoA), and MTDIR-based dose addition (MA).
The mean DSC values of MTDIR, VoxelMorph, and Velocity for the bladder were 0.78, 0.75, and 0.72 for the registration between CT scans of EBRT and the last ICBT, respectively. The mean DSC values of the rectum were also equal to 0.58, 0.56, and 0.52. The mean HDmean values of MTDIR, VoxelMorph, and Velocity for the bladder were 4.81, 5.16, and 5.43, and the mean HDmean values of the rectum were 5.41, 5.81, and 6.93, respectively. For the registration between CT scans of ICBT, the mean DSC values of MTDIR, VoxelMorph, and Velocity for the bladder were obtained 0.82, 0.80, and 0.77, and the mean DSC values for the rectum were equal to 0.70, 0.68, and 0.63, respectively. The mean HDmean values of MTDIR, VoxelMorph, and Velocity for the bladder were 4.22, 4.58, and 4.79, and the mean HDmean values of the rectum were obtained 4.86, 5.17, and 5.64, respectively. The results generally suggested that MTDIR outperformed VoxelMorph and Velocity.
The study findings demonstrated that the model developed based on parameters obtained from the proposed method exhibited higher registration accuracy.
基于宫颈癌内外放疗的联合模式，本研究旨在探究一种基于精确变压器的可变形图像配准（DIR）方法用于累积剂量评估。
根据对180例接受腔内近距离放疗（ICBT）和外照射放疗（EBRT）的宫颈癌患者进行的回顾性分析，本研究提出了一种基于混合变压器结构的可变形图像配准（MTDIR）网络，用于配准ICBT和EBRT的CT扫描图像，随后进行剂量累积和评估。计算直肠和膀胱的平均骰子相似系数（DSC）和豪斯多夫距离（HD），以比较MTDIR与最先进的VoxelMorph方法以及Velocity提供的DIR方法的性能。此外，计算了四种方法对膀胱和直肠的累积剂量：直接DVH参数相加（DA）、Velocity提供的基于DIR的剂量相加（VA）、基于VoxelMorph的剂量相加（VoA）和基于MTDIR的剂量相加（MA）。
对于EBRT与最后一次ICBT的CT扫描图像配准，MTDIR、VoxelMorph和Velocity对膀胱的平均DSC值分别为0.78、0.75和0.72。直肠的平均DSC值也分别为0.58、0.56和0.52。MTDIR、VoxelMorph和Velocity对膀胱的平均HDmean值分别为4.81、5.16和5.43，直肠的平均HDmean值分别为5.41、5.81和6.93。对于ICBT的CT扫描图像配准，MTDIR、VoxelMorph和Velocity对膀胱的平均DSC值分别为0.82、0.80和0.77，直肠的平均DSC值分别为0.70、0.68和0.63。MTDIR、VoxelMorph和Velocity对膀胱的平均HDmean值分别为4.22、4.58和4.79，直肠的平均HDmean值分别为4.86、5.17和5.64。结果总体表明MTDIR优于VoxelMorph和Velocity。
研究结果表明，基于所提出方法获得的参数开发的模型具有更高 的配准精度。
