Accuracy of deformable image registration for contour propagation in adaptive lung radiotherapy

Nicholas Hardcastle, Wouter van Elmpt, Dirk De Ruysscher, Karl Bzdusek, Wolfgang A. Tomé

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Background: Deformable image registration (DIR) is an attractive method for automatic propagation of regions of interest (ROIs) in adaptive lung radiotherapy. This study investigates DIR for automatic contour propagation in adaptive Non Small Cell Lung Carcinoma patients.Methods: Pre and mid-treatment fan beam 4D-kVCT scans were taken for 17 NSCLC patients. Gross tumour volumes (GTV), nodal-GTVs, lungs, esophagus and spinal cord were delineated on all kVCT scans. ROIs were propagated from pre- to mid-treatment images using three DIR algorithms. DIR-propagated ROIs were compared with physician-drawn ROIs on the mid-treatment scan using the Dice score and the mean slicewise Hausdorff distance to agreement (MSHD). A physician scored the DIR-propagated ROIs based on clinical utility.Results: Good agreement between the DIR-propagated and physician drawn ROIs was observed for the lungs and spinal cord. Agreement was not as good for the nodal-GTVs and esophagus, due to poor soft-tissue contrast surrounding these structures. 96% of OARs and 85% of target volumes were scored as requiring no or minor adjustments.Conclusions: DIR has been shown to be a clinically useful method for automatic contour propagation in adaptive radiotherapy however thorough assessment of propagated ROIs by the treating physician is recommended.

Original languageEnglish (US)
Article number243
JournalRadiation Oncology
Issue number1
StatePublished - Oct 18 2013


  • Adaptive radiotherapy
  • Automatic contour propagation
  • Deformable image registration

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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