Identification of patterns of tumour change measured on CBCT images in NSCLC patients during radiotherapy

Physics in Medicine and Biology
Lameck Mbangula AmugongoAlan McWilliam

Abstract

In this study, we propose a novel approach to investigate changes in the visible tumour and surrounding tissues with the aim of distinguishing modes of tumour change (elastic versus non-elastic) without segmentation on the follow-up images. On-treatment cone-beam computed tomography (CBCT) images of 240 non-small cell lung cancer (NSCLC) patients who received 55 Gy of radiotherapy were included. CBCTs were aligned onto planning computed tomography (planning CT) scan using a two-step rigid registration process. To explore density changes across the lung-tumour boundary, eight shells confined to the shape of the gross tumour volume (GTV) were created. The shells extended 6 mm inside and outside of the GTV border, and each shell is 1.5 mm thick. After applying intensity correction on CBCTs, the mean intensity was extracted from each shell across all CBCTs. Thereafter, linear fits were created, indicating density change over time in each shell during treatment. The slopes of all eight shells were clustered to explore patterns in the slopes that show how tumours change. Seven clusters were obtained, 97% of the patients were clustered into three groups. After visual inspection, we found that these clusters represented patients with l...Continue Reading

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Oct 14, 2021·Physics in Medicine and Biology·Lameck Mbangula AmugongoAlan McWilliam

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