Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;67(4):318-332.
doi: 10.1002/jmrs.417. Epub 2020 Aug 2.

Deforming to Best Practice: Key considerations for deformable image registration in radiotherapy

Jeffrey Barber  1   2 , Johnson Yuen  3   4   5 , Michael Jameson  6   4   5 , Laurel Schmidt  3 , Jonathan Sykes  1   2 , Alison Gray  6   4   5 , Nicholas Hardcastle  7   8 , Callie Choong  6 , Joel Poder  3   8 , Amy Walker  6   4   5 , Adam Yeo  7   9 , Ben Archibald-Heeren  10 , Kristie Harrison  11 , Annette Haworth  2 , David Thwaites  1   2
Affiliations

Deforming to Best Practice: Key considerations for deformable image registration in radiotherapy

Jeffrey Barber et al. J Med Radiat Sci. 2020 Dec.

Abstract

Image registration is a process that underlies many new techniques in radiation oncology - from multimodal imaging and contour propagation in treatment planning to dose accumulation throughout treatment. Deformable image registration (DIR) is a subset of image registration subject to high levels of complexity in process and validation. A need for local guidance to assist in high-quality utilisation and best practice was identified within the Australian community, leading to collaborative activity and workshops. This report communicates the current limitations and best practice advice from early adopters to help guide those implementing DIR in the clinic at this early stage. They are based on the state of image registration applications in radiotherapy in Australia and New Zealand (ANZ), and consensus discussions made at the 'Deforming to Best Practice' workshops in 2018. The current status of clinical application use cases is presented, including multimodal imaging, automatic segmentation, adaptive radiotherapy, retreatment, dose accumulation and response assessment, along with uptake, accuracy and limitations. Key areas of concern and preliminary suggestions for commissioning, quality assurance, education and training, and the use of automation are also reported. Many questions remain, and the radiotherapy community will benefit from continued research in this area. However, DIR is available to clinics and this report is intended to aid departments using or about to use DIR tools now.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The typical image registration process, where a moving or deforming image is transformed to match a reference image. The same process is used for rigid and deformable registration; however, different similarity metrics, optimisation and transformation algorithms are used.
Figure 2
Figure 2
An example patient process map, indicating the imaging data that can be acquired at each phase of treatment, and below, the image registration‐related tasks (both deformable and rigid) are indicated across the time period and types of images they may occur.
Figure 3
Figure 3
Development process of the advice in this report.
See this image and copyright information in PMC

References

    1. Brock KK, Mutic S, McNutt TR, Li H, Kessler ML. Use of image registration and fusion algorithms and techniques in radiotherapy: Report of the AAPM radiation therapy committee task group no. 132. Med Phys 2017; 44: e43–e76. - PubMed
    1. Oh S, Kim S. Deformable image registration in radiation therapy. Radiat Oncol J 2017; 35: 101–11. - PMC - PubMed
    1. Rigaud B, Simon A, Castelli J, et al. Deformable image registration for radiation therapy: principle, methods, applications and evaluation. Acta Oncol (Madr) 2019; 58: 1225–37. - PubMed
    1. Brouwers MC, Kerkvliet K, Spithoff K. AGREE next steps consortium ANS. The AGREE reporting checklist: a tool to improve reporting of clinical practice guidelines. BMJ 2016; 352: i1152. - PMC - PubMed
    1. Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: The RIGHT statement. Ann Intern Med 2017; 166: 128. - PubMed

MeSH terms