Evaluation of the XVI dual registration tool for image-guided radiotherapy in prostate cancer

Filipa Sousa; Younes Jourani; Robbe Van den Begin; François-Xavier Otte; Sara Ridai; Maxime Desle; Angela Ferreira; Radia Ahmimed; Moniek C M van Klink-de Goeij; Dirk Van Gestel

doi:10.1016/j.tipsro.2021.03.003

Evaluation of the XVI dual registration tool for image-guided radiotherapy in prostate cancer

Tech Innov Patient Support Radiat Oncol. 2021 Apr 20:18:22-28. doi: 10.1016/j.tipsro.2021.03.003. eCollection 2021 Jun.

Affiliations

¹ Radiation Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
² Inholland University of Applied Sciences, School of Health, Haarlem, The Netherlands.
³ Medical Physics Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.

Abstract

Purpose: To compare the reliability and the required time for two cone-beam CT (CBCT) registration methods for prostate irradiation (PI) and prostate bed irradiation (PBI).

Material and methods: Two-hundred treatment fractions (in 10 PI and 10 PBI patients) were reanalyzed, using two CBCT registration methods: (1) a combination of an automated chamfer matching (CM) with manual matching (MM), and (2) the automated XVI dual registration tool (DRT). Bland-Altman 95% Limits of Agreement (LoA) were used to assess agreement with manual registration by Radiation Oncologists.

Results: All 95% LoA for CM + MM were ≤ 0.33 cm. For DRT, several 95% LoA were notably larger than the predefined clinical threshold of 0.3 cm: -0.47 to +0.25 cm (PI) and -0.36 to +0.23 cm (PBI) for the superior-inferior direction and -0.52 to +0.24 cm (PI) and -0.38 to +0.31 cm (PBI) for the anterior-posterior direction.For PI, the average time required was 33 s with CM + MM versus only 18 s with DRT (p = 0.002). For PBI, this was 13 versus 19 s, respectively (p = 0.16).

Conclusion: For PI, DRT was significantly faster than CM + MM, but the accuracy is insufficient to use without manual verification. Therefore, manual verification is still warranted, but could offset the time benefit. For PBI, the CM + MM method was faster and more accurate.