Deformable
image registration (DIR) has been an important component in adaptive
radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice
similarity coefficient (DSC) and to determine the optimal timing of replanning.
A total of 22 patients who underwent volume modulated arc therapy (VMAT) for
head and neck (H&N) cancers were prospectively analyzed. The planning
target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second
planning CT scan (rescan) was performed at the 15th fraction. The DSC was
calculated for each structure on both CT scans. The continuous variables to
predict the need for replanning were assessed. The optimal cut-off value was
determined using receiver operating characteristic (ROC) curve analysis. In the
correlation between body weight loss and DSC of each structure, weight loss
correlated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51).
Patients who required replanning tended to have experienced rapid weight loss.
The threshold DSC was 0.98 and 0.60 in the whole face and the face surface,
respectively. Patients who showed low DSC in the whole face and the face
surface required replanning at a significantly high rate (P < 0.05 and P
< 0.01). Weight loss correlated with DSC in both the whole face and the face
surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the
need for replanning. In addition, weight loss tended to correlate with DSC. DIR
during ART was found to be a useful tool for replanning.
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