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New model for PET/CT image processing and radiotherapy planning based on dose painting

AuthorsJiménez Ortega, Elisa; Balcerzyk, Marcin ; Fernández-Maza, L. ; Parrado-Gallego, Ángel; Hevilla, Juan; Leal, Antonio
Issue Date2016
CitationImaging 2016
Abstract[Introduction]: Dose Painting (DP) is a radiotherapy treatment strategy for delivering a nonuniform dose distribution with a prescription based on the new concept of biological target volumes (BTVs) from medical images. Two approaches are being evaluated: threshold-based dose painting by contours (DPBC), and voxel-based dose painting by numbers (DPBN). The study of the impact of different developed PET image reconstruction protocols on the segmentation of the BTVs for DPBC, and the generation of the dose prescription maps for DPBN are topics under study in processing image for nuclear medicine and radiotherapy. [Purpose]: To present a new model for assessing the effect on the radiotherapy treatment planning of using different acquisition and reconstruction protocols for morpho-functional image from PET/CT before incorporating their use in the clinical routine. [Material and methods]: We used Siemens Biograph mCT PET/CT clinical scanner with Syngo V51C acquisition software. Acquisition and reconstruction methods for EARL (ResEARch for Life R , http://earl.eanm.org) [18F]FDG-PET/CT accreditation were carried out and a protocol for maximize Recovery Coefficient (RC) in Image Quality NEMA 2007 phantom was also implemented. The scanner and software apart from typical corrections allows Time of Flight correction, iterative OSEM reconstruction and application of Point Spread Function. Beyond the deviations already observed between dose prescriptions maps and the different reconstructed SUV images, in order to assess the impact of different reconstruction methods on the treatment planning algorithm, actual clinical cases should be also planned for both a dose painting by contours (DPBC) and a dose painting by numbers (DPBN) strategy. However, as far as we know, planning of DPBN is not supported by commercial treatment planning system. To make possible this evaluation, a novel algorithm has been developed for planning based on inverse planning, including an optimization method at the voxel level, so restriction of dose to volumes from a previous segmentation process in the image is not necessary. The software was implemented in our in-house platform CARMEN, based on Matlab (http://grupos.us.es/medicalphysics/) for radiotherapy research. New image processing methods for generating the previous maps to the optimization process and new metrics for the evaluation of results were implemented in CARMEN platform. The platform was developed for the easy implementation of new algorithms under evaluation and then, to be applied to imported clinical cases. [Results]: The different reconstruction methods for the generation of prescription dose maps for DPBN and different semiautomatic segmentation algorithms for DBPN showed relevant discrepancies in covering tumor and unwished doses in healthy tissue and organs at risk. These results evidenced the need to incorporate standard protocols in the processing of PET/CT images for radiotherapy planning. [Conclusions]: A new model was presented for the correct evaluation of the influence in the radiotherapy planning of the implementation of different reconstruction methods and thresholds of morpho-functional information by PET/CT image processing.
DescriptionResumen del póster presentado a la international conference on imaging techniques in subatomic physics, astrophysics, medicine, biology and industry; celebrada en Estocolmo (Suecia) del 13 al 16 de junio de 2016.-- et al.
Appears in Collections:(CNA) Comunicaciones congresos
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