Fifty-seventh annual meeting of the American association of physicists in medicine
TU-AB-303-11: Predict Parotids Deformation Applying SIS Epidemiological Model in H&N Adaptive RT
The aim is to investigate the use of epidemiological models to predict morphological variations in patients undergoing radiation therapy (RT). The susceptible-infected-susceptible (SIS) deterministic model was applied to simulate warping within a focused region of interest (ROI). Hypothesis is to consider each voxel like a single subject of the whole sample and to treat displacement vector fields like an infection.
Using Raystation hybrid deformation algorithms and automatic re-contouring based on mesh grid, we post-processed 360 MVCT images of 12 H&N patients treated with Tomotherapy. Study focused on parotid glands, identified by literature and previous analysis, as ROI more susceptible to warping in H&N region. Susceptible (S) and infectious (I) cases were identified in voxels with inter-fraction movement respectively under and over a set threshold. IronPython scripting allowed to export positions and displacement data of surface voxels for every fraction. A MATLAB homemade toolbox was developed to model the SIS.
SIS model was validated simulating organ motion on QUASAR phantom. Applying model in patients, within a [0–1cm] range, a single voxel movement of 0.4cm was selected as displacement threshold. SIS indexes were evaluated by MATLAB simulations. Dynamic time warping algorithm was used to assess matching between model and parotids behavior days of treatments. The best fit of the model was obtained with contact rate of 7.89±0.94 and recovery rate of 2.36±0.21.
SIS model can follow daily structures evolutions, making possible to compare warping conditions and highlighting challenges due to abnormal variation and set-up errors. By epidemiology approach, organ motion could be assessed and predicted not in terms of average of the whole ROI, but in a voxel-by-voxel deterministic trend. Identifying anatomical region subjected to variations, would be possible to focus clinic controls within a cohort of pre-selected patients eligible for adaptive RT.
The research is partially co-funded by the Italian Research Grant: Dose warping methods for IGRT and Adaptive RT: dose accumulation based on organ motion and anatomical variations of the patients during radiation therapy treatments,MoH (GR-2010-2318757) and Tecnologie Avanzate S.r.l.(Italy)