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
OPEN ACCESS
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.
Conformal radiotherapy, ultrasound imaging, optical stereolocalisation, prostate model, segmentation, registration
Mots clés
Radiothérapie conformationnelle, échographie, stéréolocalisation optique, modélisation prostate, segmentation, recalage
[Artignan 2004] ARTIGNAN X., SMITSMANS Monique H.-P., LEBESQUE J.-V., JAFFRAY D.-A., VAN HER M., BARTELINK H., Online Ultrasound Image Guidance for Radiotherapy of Prostate Cancer: Impact of Image Acquisition on Prostate Displacement., Int.J Radiat.Oncol.Biol.Phys 59[2], 595-601. 2004.
[Berger 1997] BERGER M., DANUSER G., Deformable Multi Template Matching with Application to Portal Images, Conference on Computer Vision and Pattern Recognition, IEEE Computer Society Press, 1997.
[Besl 1992] BESL P.J, N.-D. MCKAY, A Method for Registration of 3-D Shapes, IEEE Transactions on Pattern Analysis and Matching Intelligence, 14[2], 239-256. 1992.
[Betrouni 2005] BETROUNI N., VERMANDEL M., PASQUIER D., MAOUCHE S., ROUSSEAU J., Segmentation of abdominal ultrasound images of the prostate using a priori information and an adapted noise filter, Computerized Medical Imaging and Graphics 29[1], 43-51, 2005.
[Blackall 2000] BLACKALL J.M., RUECKERT D., MAURER C. R. Jr., PENNEY G.-P., HILL D.L.G., HAWKES D.J., An Image Registration Approach To Automated Calibration for Freehand 3D Ultrasound. Medical Image Computing and Computer-Assisted Intervention (MICCAI), [Springer], 2000, Pittsburg, USA.
[Blackall 2005] BLACKALL J.-M., PENNEY G.P., KING A.P., HWKESD.J, Alignement of Sparse Freehand 3D Ultrasound With Preoperative Images of the Liver Using Models of Respiratoty Motion and Deformation, IEEE TMI 24(11), pp. 1405-1416, 2005.
[Brunie 1992] BRUNIE L., Fusion d’images médicales multimodales, Thèse de Doctorat. Université Grenoble 1. 1992.
[Carr 1998] CARR J.C., FRIGHT W. R., GEE A. H., PRAGER R.W., DALTON K. J., 3D Shape Reconstruction using Volume Intersection Techniques, Proc. of the IEEE Intl. Conf. Comp. Vision, Bombay, India, 1095-1110. 1998.
[Clippe 2003] CLIPPE S. SARRUT D. MALET C. MIGUET S. GINESTET C. CARRIE C., Patient setup error measurement using 3D intensity-based image registration techniques, Int.J Radiat.Oncol.Biol.Phys 56[1], 259-265. 2003.
[Connor 1975] CONNOR WG M. L. M. B., VEOMETT R., HICKS J., MILLER R.C., MAYER E., SHEELEY N. Patient repositioning and motion detection using a video cancellation system, Technical Innovations, 1975.
[Coste 1997] COSTE E., GIBON D., BOUREL P., BALLET E., ROUSSEAU J., Real Time 3D Localization of Objects with Two Standards CCD Cameras. Medical & Biological Engineering & Computing: World Congress on Medical Physics and Biomedical Engineering. XVIII International Conference. 35[Part 1], 375, 1997.
[Cootes 1995] COOTES T.F. C. J., TAYLOR D. H., COOPER J., GRAHAM., Active Shape Models-Their Training and Applications, Computer Vision and Image Understanding 61, 38-59, 1995.
[Court 2003] COURT L R. L., MOHAN R., DONG L., Evaluation of mechanical precision and alignment uncertainties for an integrated CT/LINAC system, Medical Physics 30[6], 1198-1210, 2003.
[Feschet 1999] FESCHET F. D., SARRUT S., MIGUET., Automated Position Control in Conformal Radiotherapy. Technical Report, Laboratoire ERIC, Lyon, 1999.
[Fitzpatrick 1998] FITZPATRICK J.M., WEST J.B., MAURER C.R., Predecting Error in Rigid-Body Point-Based Registration, IEEE Trans. in Med. Imaging 17[5], 694-702, 1998.
[Ford 2002] FORD EC C. J., MUELLER K., SIDHU K., TODOR D., MAGERAS G., YORKE E., LING CC., AMOLS H., Cone-beam CT with megavoltage beams and an amorphous silicon electronic portal imaging device: potential for verification of radiotherapy of lung cancer, Medical Physics 29[12], 2913-2924, 2002.
[Fritsch 1994] FRITSCH D.S., PIZER S. M., CHANEY E. L., LIU A., RAGHAVAN S., Cores for Image Registration, 2167[Medical Imaging: Image Processing], 128-142, 1994.
[Hanley 1997] HANLEY J., MOIRA A., LUMLEY GIG S., MAGERAS J., SUN M. J., ZELEFSKY S.A., LEIBEL Z., FUKS G.J., KUTCHER., Measurement of patient positioning errors in three-dimensional conformal radiotherapy of the prostate. Int. J. Radiation Oncology Biol. Phys., 37[2], 435-444, 1997.
[Jaffray 2002] JAFFRAY DA S. J., WONG JW., MARTINEZ AA., Flatpanel cone-beam computed tomography for image-guided radiation therapy, Int.J Radiat.Oncol.Biol.Phys 53[5], 1337-1349, 2002.
[Kaplan 2002] KAPLAN I., OLDENBURG N.E, MESKELL P., BLAKEM., CHRCH P., HOLUPKA E. J., Real Time MRI-ultrasound image guided stereotactic prostate biopsy, Magnetic Resonance Imaging 20, 295-299, 2002.
[Kuhr 1998] KUHR G C. L., SCHLEGEL W., Patient Positioning Sensor Unit (PPSU) for stereotactically guided fractioned radiotherapy, ESTRO 17 Annual Meeting, 1998, Edinburgh.
[Kulik 2002] KULIK C., CAUDRELIER J.-M., VERMANDEL M., CASTELAIN B., MAOUCHE S., ROUSSEAU J., Conformal radiotherapy optimization with micro-multileaf collimators: comparison with radiosurgery techniques, Int. J. Radiation Oncology Biol. Phys, 53[4], 1038-1050. 2002.
[Lattanzi 1999] LATTANZI J.M. S., PINOVER W., HORWITZ E., DAS I., SCHULTHEISS TE., HANKS GE., A comparison of daily CT localization to a daily ultrasound-based system in prostate cancer, Int. J Radiat. Oncol. Biol. Phys 43[4], 719-725, 1999.
[Lavallée 1995] LAVALLÉE S., SZELISKI R., Recovering the position and orientation of Free-Form Objects from Image Contours Using 3D Distance Maps, IEEE Transactions on Pattern Analysis and Machine Intelligence 17[4], 378-390, 1995.
[Lavallée 1991] LAVALLÉE S., SZELISKI R., BRUNIE L., Matching 3D smooth surfaces with their 2D projections using 3D distance maps. SPIE Vol. 1570[Geometric Methods in Computer Vision], 322-336, 1991, San Diego, CA, July.
[Little 2003] LITTLE DJ D. L., LEVY LB., CHANDRA A., KUBAN DA., Use of portal images and BAT ultrasonography to measure setup error and organ motion for prostate IMRT: implications for treatment margins. Int.J Radiat. Oncol. Biol.Phys 56[5], 1218-1224. 2003.
[Lunn 2003] LUNN KAREN E., PAULSEN KEITH D., ROBERTS DAVIDW., KENNEDY FRANCIS E., HARTOV ALEX, WEST JOHN D., Displacement estimation with Co-registred Ultrasound for image guided neurosurgery: A quantitative In Vivo Porcine study, IEEE Trans. in Med. Imaging 22[11], 1358-1368, 2003.
[Malone 2000] MALONE S., CROOK JM., KENDAL WS., Respiratoryinduced prostate motion: Quantification and characterization. Int. J. Radiation Oncology Biol. Phys. 48, 551-557, 2000.
[Milliken 1997] MILLIKEN BD R. S., HAMILTON RJ., JOHNSON LS., CHEN GT., Performance of a video-image subtraction-based patient positioning system. Int.J Radiat. Oncol. Biol. Phys 38[4], 855-866, 1997.
[Palos 2003] PALOS G. VERMANDEL M., PASQUIER D., ARUFAS S., DEVLAMINCK V., ROUSSEAU J., Recalage élastique d’images abdominales. [12ème Forum des jeunes chercheurs en génie biologique et médical], 152-153. 2003, Nantes.
[Palos 2004] G. PALOS, BETROUNI N., COULANGES M., VERMANDEL M., DEVLAMINCK V., ROUSSEAU J., Multimodal matching by maximisation of mutual information and optical flow technique, IEEE EMBS, pp. 1679-1682, San Francisco, 2004.
[Penney 2001] PENNEY G.P., BLACKALL J. M., HAYASHI D., SABHARWAL T., HAWKES A. A., HAWKED D. J., Overview of an ultrasound to CT or MR registration system for use in thermal ablation of liver metastases, Proceedings of the 6th Scandinavian conference on image analysis, pages. 2001.
[Porter 2001] PORTER B.C., RUBENS D. J., STRANG J. G., TOTTERMAN S., PARKER K. J., Three-Dimensional Registration and Fusion of Ultrasound and MRI Using Major Vessels and Fiducial Markers, IEEE Trans. in Med. Imaging 20[4], 354-359, 2001.
[Rosenthal 1993] ROSENTHAL S., ROACH M., GOLDSMITH B., Immobilization improves the reproducibility of patient positioning during six-field conformal radiation therapy for prostate carcinoma. Int. J Radiat. Oncol. Biol. Phys 27, 921-926, 1993.
[Sarrut 2000] SARRUT D., CLIPPE S., Patient positioning in radiotherapy by registration of 2D portal to 3D CT images by a contend-based research with similarity measures. Computer Assisted Radiology and Surgery, 707-712, 2000.
[Serago 2002] SERAGO C.F., CHUNGBIN S. J., BUSKIRK S. J., EZZELLG.A., COLLIE A. C., VORA S. A., Initial experience with ultrasound localization for positioning prostate cancer patients for external beam radiotherapy. Int. J. Radiation Oncology Biol. Phys, 53[5], 1130-1138, 2002.
[Song 1996] SONG PJ., WASHINGTON M., VAIDA F. et al., A comparison of four patient immobilization devices in the treatment of prostate cancer patients with three dimensional conformal radiotherapy. Int. J. Radiat. Oncol. Biol. Phys, 34, 213-219, 1996.
[Troccaz 1993] TROCCAZ J., MENGUY Y., BOLLA M., CINQUIN Ph., VASSAL P., LAIEB N., DESBAT L., DUSSERRE A., DAL SOGLIOS., Conformal external radiotherapy of prostatic carcinoma: requirements and experimental results. Radiotherapy and Oncology 29, 176-183, 1993.
[Vassal 1995] VASSAL P., TROCCAZ J., LAIEB N., CINQUIN P., BOLLAM., BERLAND E., Introducing computer vision sensors in radiotherapy for accurate dose delivery. Medical Robotics and Computer Assisted Surgery , 16-23. 1995.