Repositionnement du patient en radiothérapie conformationnelle du cancer de la prostate par recalage d’images échographiques et d’images de résonance magnétique

Repositionnement du patient en radiothérapie conformationnelle du cancer de la prostate par recalage d’images échographiques et d’images de résonance magnétique

Patient Setup in Conformal Radiotherapy of Prostate Cancer by Registration of Ultrasound and Magnetic Resonance Images

Nacim Betrouni Maximilien Vermandel  David Pasquier  Salah Maouche  Jean Rousseau 

INSERM, U 703 : ThIAIS, Pavillon Vancostenobel, CHRU Lille Cedex

UPRES EA 1049, Laboratoire de Biophysique, Université de Lille II

CRLCC Oscar LAMBRET, BP307, 59020 LILLE Cedex

Laboratoire LAGIS CNRS UMR 8146 : USTL, Bâtiment P2 59655 Villeneuve d’Ascq

Corresponding Author Email: 
n-betrouni@chru-lille.fr
Page: 
321-333
|
Received: 
3 January 2006
|
Accepted: 
N/A
|
Published: 
31 August 2006
| Citation

OPEN ACCESS

Abstract: 

In conformal radiotherapy, beam set up and dose calculations are achieved using images obtained from computed tomography (CT) or magnetic resonance (MR). These images are taken before the treatment which is performed on several sessions on several weeks. At the beginning of each session, the patient has to be positioned on the treatment couch under the linear accelerator in the same position as during MR or CT imaging and planning, and the organs are assumed to be in the same place. Currently, the methods used for this repositioning are based on the external anatomy of the patient and suppose an immobility of the internal structures. In this study, we present a new approach, suited to the clinical practice, for the automatic repositioning of patient in prostate cancer radiotherapy. It is based on localisation by ultrasound images and optical stereolocalisation and on a matching with images regenerated in the planning volume. The method exploits a statistical model of the prostate to automatically extract its contours. The first tests in conditions of a radiotherapy session show that the method is able to obtain a patient setup with an accuracy of about 1.4 mm.

Résumé

En radiothérapie conformationnelle, le calcul des doses et des balistiques des faisceaux à appliquer pour irradier la tumeur se fait en se basant sur des images tomographiques (IRM ou scanner (TDM)) réalisées avant le traitement. Celui-ci dure plusieurs séances réparties sur plusieurs semaines. Au début de chaque séance le patient doit être installé sur la table de traitement dans les conditions initiales de planification. Actuellement, les méthodes les plus utilisées pour ce repositionnement se basent sur l'anatomie externe du patient et supposent une immobilité des organes internes. De ce fait, des marges d'erreurs sont prévues dans la définition des volumes pour prendre en considération ces mouvements et les erreurs du repositionnement. Ce travail présente une nouvelle approche, adaptée aux conditions cliniques, pour le repositionnement automatique du patient en radiothérapie de la prostate. Elle est basée sur un repérage temps réel par échographie et une mise en correspondance rapide et précise avec des images générées dans le volume de planification. La méthode exploite une modélisation statistique de la prostate pour extraire automatiquement ses contours. Les premiers tests de la méthode dans les conditions réelles d'une séance de radiothérapie montrent que le repositionnement peut être obtenu avec une précision de l'ordre de 1.4 mm.

Keywords: 

Conformal radiotherapy, ultrasound imaging, optical stereolocalisation, prostate model, segmentation, registration

Mots clés

Radiothérapie conformationnelle, échographie, stéréolocalisation optique, modélisation prostate, segmentation, recalage

1. Introduction
2. Position Du Problème
3. État De L’art Du Recalage D’images D’IRM Et D’échographie
4. Méthode
5. Expérimentations Et Résultats
6. Discussion
7. Conclusion
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