Faculty, Staff and Student Publications
Publication Date
5-1-2023
Journal
Radiotherapy Oncology
Abstract
Dose mapping/accumulation (DMA) is a topic in radiotherapy (RT) for years, but has not yet found its widespread way into clinical RT routine. During the ESTRO Physics workshop 2021 on "commissioning and quality assurance of deformable image registration (DIR) for current and future RT applications", we built a working group on DMA from which we present the results of our discussions in this article. Our aim in this manuscript is to shed light on the current situation of DMA in RT and to highlight the issues that hinder consciously integrating it into clinical RT routine. As a first outcome of our discussions, we present a scheme where representative RT use cases are positioned, considering expected anatomical variations and the impact of dose mapping uncertainties on patient safety, which we have named the DMA landscape (DMAL). This tool is useful for future reference when DMA applications get closer to clinical day-to-day use. Secondly, we discussed current challenges, lightly touching on first-order effects (related to the impact of DIR uncertainties in dose mapping), and focusing in detail on second-order effects often dismissed in the current literature (as resampling and interpolation, quality assurance considerations, and radiobiological issues). Finally, we developed recommendations, and guidelines for vendors and users. Our main point include: Strive for context-driven DIR (by considering their impact on clinical decisions/judgements) rather than perfect DIR; be conscious of the limitations of the implemented DIR algorithm; and consider when dose mapping (with properly quantified uncertainties) is a better alternative than no mapping.
Keywords
Humans, Radiotherapy Dosage, Radiation Oncology, Radiotherapy Planning, Computer-Assisted, Algorithms, Image Processing, Computer-Assisted, Dose mapping/accumulation, Deformable image registration (DIR), DIR uncertainties, Impact of dose mapping uncertainties, Anatomical changes, Dose mapping/accumulation landscape (DMAL)
DOI
10.1016/j.radonc.2023.109527
PMID
36773825
PMCID
PMC11877414
PubMedCentral® Posted Date
3-4-2025
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Medical Sciences Commons, Oncology Commons, Radiation Medicine Commons, Radiology Commons