Investigation of the clinical inter-observer bias in prostate fiducial marker image registration between CT and MR images.
Aged
Aged, 80 and over
Fiducial Markers
Follow-Up Studies
Humans
Image Processing, Computer-Assisted
/ methods
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Observer Variation
Organs at Risk
/ radiation effects
Prognosis
Prostatic Neoplasms
/ diagnostic imaging
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
/ methods
Radiotherapy, Intensity-Modulated
/ methods
Retrospective Studies
Tomography, X-Ray Computed
/ methods
Workflow
Computed tomography
Fiducial marker
Image registration
Inter-observer
Magnetic resonance imaging
Prostate cancer
Registration uncertainty
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
16 Aug 2021
16 Aug 2021
Historique:
received:
12
01
2021
accepted:
17
07
2021
entrez:
17
8
2021
pubmed:
18
8
2021
medline:
11
1
2022
Statut:
epublish
Résumé
Inter-modality image registration between computed tomography (CT) and magnetic resonance (MR) images is associated with systematic uncertainties and the magnitude of these uncertainties is not well documented. The purpose of this study was to investigate the potential uncertainty of gold fiducial marker (GFM) registration for localized prostate cancer and to estimate the inter-observer bias in a clinical setting. Four experienced observers registered CT and MR images for 42 prostate cancer patients. Manual GFM identification was followed by a landmark-based registration. The absolute difference between observers in GFM identification and the displacement of the clinical target volume (CTV) was investigated. The CTV center of mass (CoM) vector displacements, DICE-index and Hausdorff distances for the observer registrations were compared against a clinical baseline registration. The time allocated for the manual registrations was compared. Absolute difference in GFM identification between observers ranged from 0.0 to 3.0 mm. The maximum CTV CoM displacement from the clinical baseline was 3.1 mm. Displacements larger than or equal to 1 mm, 2 mm and 3 mm were 46%, 18% and 4%, respectively. No statistically significant difference was detected between observers in terms of CTV displacement. Median DICE-index and Hausdorff distance for the CTV, with their respective ranges were 0.94 [0.70-1.00] and 2.5 mm [0.7-8.7]. Registration of CT and MR images using GFMs for localized prostate cancer patients was subject to inter-observer bias on an individual patient level. A CTV displacement as large as 3 mm occurred for individual patients. These results show that GFM registration in a clinical setting is associated with uncertainties, which motivates the removal of inter-modality registrations in the radiotherapy workflow and a transition to an MRI-only workflow for localized prostate cancer.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Inter-modality image registration between computed tomography (CT) and magnetic resonance (MR) images is associated with systematic uncertainties and the magnitude of these uncertainties is not well documented. The purpose of this study was to investigate the potential uncertainty of gold fiducial marker (GFM) registration for localized prostate cancer and to estimate the inter-observer bias in a clinical setting.
METHODS
METHODS
Four experienced observers registered CT and MR images for 42 prostate cancer patients. Manual GFM identification was followed by a landmark-based registration. The absolute difference between observers in GFM identification and the displacement of the clinical target volume (CTV) was investigated. The CTV center of mass (CoM) vector displacements, DICE-index and Hausdorff distances for the observer registrations were compared against a clinical baseline registration. The time allocated for the manual registrations was compared.
RESULTS
RESULTS
Absolute difference in GFM identification between observers ranged from 0.0 to 3.0 mm. The maximum CTV CoM displacement from the clinical baseline was 3.1 mm. Displacements larger than or equal to 1 mm, 2 mm and 3 mm were 46%, 18% and 4%, respectively. No statistically significant difference was detected between observers in terms of CTV displacement. Median DICE-index and Hausdorff distance for the CTV, with their respective ranges were 0.94 [0.70-1.00] and 2.5 mm [0.7-8.7].
CONCLUSIONS
CONCLUSIONS
Registration of CT and MR images using GFMs for localized prostate cancer patients was subject to inter-observer bias on an individual patient level. A CTV displacement as large as 3 mm occurred for individual patients. These results show that GFM registration in a clinical setting is associated with uncertainties, which motivates the removal of inter-modality registrations in the radiotherapy workflow and a transition to an MRI-only workflow for localized prostate cancer.
Identifiants
pubmed: 34399806
doi: 10.1186/s13014-021-01865-8
pii: 10.1186/s13014-021-01865-8
pmc: PMC8365967
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
150Subventions
Organisme : VINNOVA
ID : 2016-03847
Organisme : VINNOVA
ID : 2016-02529
Organisme : Allmänna Sjukhusets i Malmö Stiftelse för Bekämpande av Cancer
ID : Allmänna Sjukhusets i Malmö Stiftelse för Bekämpande av Cancer
Organisme : Fru Berta Kamprads Stiftelse
ID : Fru Berta Kamprads Stiftelse
Organisme : SUS foundations
ID : SUS foundations
Organisme : Onkologiska klinikens stiftelse för bekämpande av cancer
ID : Onkologiska klinikens stiftelse för bekämpande av cancer
Informations de copyright
© 2021. The Author(s).
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