At the recent meeting of the American Society for Radiation Oncology (ASTRO) in San Francisco September 14-17, researchers from the University Medical Center, Groningen, The Netherlands, examined how the use of advanced imaging methods from Mirada Medical could automate patient monitoring and facilitate the broader adoption of adaptive radiotherapy (ART).

ART requires significant patient monitoring throughout the course of therapy to identify patients whose treatment might need to be replanned. Implementing an effective patient monitoring solution could result in significant time savings.

Researchers studied 28 patients with locally advanced cancer in the head and neck who were treated with intensity modulated radiation therapy (IMRT). Planning target volumes and at-risk organs were contoured on the planning CT and propagated to a rescan using Mirada RTx deformable image registration, and then evaluated for dose distribution. Instead of making a replan decision according to the usual method of applying constraints to the recalculated dose on the rescan, researchers developed a dose projection method. They applied a rigid translation to the original dose mapped onto the rescan. The same set of constraints was then applied to this resulting dose, in order to decide whether a replan was required.

The study found that the automated dose projection method correctly removed 90% of cases from further evaluation, while identifying 100% of those that required investigation. According to Mirada Medical, the findings indicate that rigid dose projection onto rescan CTs offers a rapid, automated substitute for dose recalculation, since only patients flagged by the system require full recalculation and treatment replanning decisions.

The study was conducted as part of Mirada Medical’s Registration Assurance program, designed to ensure DIR quality and encourage innovation in areas such as adaptive radiotherapy. “Adaptive radiotherapy presents an exciting opportunity for clinics to move to the next stage of personalized treatment,” said Timor Kadir, chief technology officer of Mirada Medical. “Mirada is committed to applying its advanced deformable registration and imaging technology for making adaptive radiotherapy practical for every clinic and every patient.”

For more information, visit Mirada Medical.

Photo caption: An ASTRO presentation from University of Groningen, The Netherlands uses Mirada Medical software to demonstrate how advanced image registration can help screen for patients requiring adaptive radiotherapy. A) Original planning CT with dose; B) The dose warped onto the re-planning CT; C) Automated estimate of dose on the replanning CT using rigid transformation. Images courtesy of Mirada Medical, USA and University Medical Center, Groningen, The Netherlands.