Course book Advanced Treatment Planning 2018

Conclusions

• QA of deformable image registration is complex

• Deformable image registrations is unsolved problem; algorithms lack biological and biomechanical knowledge • Sliding tissue • Tumor growth and regression

• This is OK to propagate OAR contours

• This is not OK for dose accumulation:

• it is unsafe to estimate you know where previous dose went

• This is not OK for adaptation around ‘shrinking’ tumors

• I therefore strongly suggest no to optimize dose on top of ‘accumulated’ dose

• Data mining gives more insight into organs at risk