Towards adaptive radiotherapy for head and neck patients: validation of an in-house deformable registration algorithm

Abstract

The purpose of this work is to validate an in-house deformable image registration (DIR) algorithm for adaptive radiotherapy for head and neck patients. We aim to use the registrations to estimate the "dose of the day" and assess the need to replan. NiftyReg is an open-source implementation of the B-splines deformable registration algorithm, developed in our institution. We registered a planning CT to a CBCT acquired midway through treatment for 5 HN patients that required replanning. We investigated 16 different parameter settings that previously showed promising results. To assess the registrations, structures delineated in the CT were warped and compared with contours manually drawn by the same clinical expert on the CBCT. This structure set contained vertebral bodies and soft tissue. Dice similarity coefficient (DSC), overlap index (OI), centroid position and distance between structures' surfaces were calculated for every registration, and a set of parameters that produces good results for all datasets was found. We achieve a median value of 0.845 in DSC, 0.889 in OI, error smaller than 2 mm in centroid position and over 90% of the warped surface pixels are distanced less than 2 mm of the manually drawn ones. By using appropriate DIR parameters, we are able to register the planning geometry (pCT) to the daily geometry (CBCT).