詳説　非剛体レジストレーション　放射線治療領域

出版社： 中外医学社
著者：
発行日： 2020-12-15
分野： 臨床医学：一般  >  放射線/核医学
ISBN： 9784498065284
電子書籍版： 2020-12-15 （1版1刷）
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商品紹介

高精度放射線治療に欠かせないツールとなりつつあるDIR．臨床で非常に有用な技術であると同時に，正しい知識を持って使用しなければ医療事故に繋がりかねない危険性も孕んでいる．本書では2018年に公開されたガイドラインを補足する形で，DIRの利用や評価方法，臨床で利用するにあたっての注意点や疑問などを114のQ＆A形式で解説．医学物理士や診療放射線技師，放射線腫瘍医など，放射線治療に関わる全ての医療従事者に役立つ1冊．

目次

  • I　概論
    　Q1 放射線治療領域におけるDIR の活用方法について教えてください．
    　Q2 本邦ではどのくらいDIR が放射線治療で活用されているか教えてください．
    　Q3 DIR ソフトウェアはどのような流れで使用されるか教えてください．
    　Q4 DIR を臨床使用するにあたり，どこで，どのくらい教育を受ける必要がありますか？
    　Q5 臨床使用するにあたってどのくらいのDIR の性能が必要か教えてください．
    　Q6 どのような症例にDIR が有効か教えてください．
    　Q7 適応放射線治療でDIR を使うとどのくらい作業を効率化できるか教えてください．
    　Q8 参考となる書籍，ガイドライン，セミナーがあれば教えてください．
    　Q9 DIR に関する文献のレビューを教えてください．
    　Q10 DIR の臨床的側面からの有用性について教えてください．
    　Q11 画像レジストレーションの概要を教えてください．
    　Q12 画像レジストレーションにおける画像類似度の評価はどのように行われるか
    　　　　 教えてください．
    　Q13 DIR のアルゴリズム（変形モデル）にはどのような種類がありますか？
    　　　　 また，どのような違いがありますか？
    　Q14 幾何学的情報（解剖学的ランドマークや輪郭情報）を用いるアルゴリズムの
    　　　　 特徴を教えてください．
    　Q15 画像レジストレーションの最適化はどのように行われるか教えてください．
    　Q16 DIR の正則化について教えてください．
    　Q17 DIR を行うときの過変形とは何ですか？　どのように対処すればよいでしょうか？
    　Q18 DIR の誤差が生じやすいのは，どのような部位ですか？
    　Q19 DIR がうまくいかなかった場合の対処法があれば，教えてください．
    　Q20 DIR パラメータの1 つの変形グリッドサイズはどのように設定すべきですか？
    　Q21 DIR の計算領域を指定するためのROI や輪郭は設定すべきですか？
    　Q22 各DIR ソフトウェアのパラメータはどのような働きをするか教えてください．
    　Q23 DIR パラメータ設定を選択する際の注意点はありますか？
    　　　　 使用するDIR パラメータは，ユーザで自由に決定してもよいものですか？
    　　　　 それとも施設内で統一パラメータを使用すべきですか？
    　Q24 DIR ソフトのパラメータは部位ごとに分けるべきですか?
    　Q25 CT とMRI などのように異なるモダリティ間でもDIR できますか？
    　Q26 DVF を使ってco-registration する時の注意点について教えてください．

    II　品質保証・品質管理
    　Q27 DIR の精度検証方法について教えてください．
    　Q28 最も効率的なDIR の評価方法もしくは評価方法の組み合わせはどれか
    　　　　 教えてください．
    　Q29 異なるモダリティ画像を用いてDIR したときのDIR 精度評価法について
    　　　　 教えてください．
    　Q30 DIR の精度評価は，部位や活用方法によって最適な方法は異なるのでしょうか．
    　Q31 ダイス係数と目標レジストレーション誤差の利点と欠点を教えてください．
    　Q32 精度検証ではダイス係数やジャッカード係数が高い数値を示せばよいのでしょうか？
    　Q33 精度評価のための解剖学的指標はどのような場所に設置すべきでしょうか？
    　　　　 注意すべき点はありますか？
    　Q34 どれほどのDIR 精度を達成すべきでしょうか？
    　　　　 DIR 結果の精度の基準値，最低限の値はいくらでしょうか？
    　Q35 DIR の結果をどのように保存すればよいでしょうか？
    　Q36 DIR のQA を行える物理ファントムはありますか？
    　Q37 DIR のコミッショニングを行う前に必要な項目について教えてください．
    　Q38 DIR のコミッショニングはどのような手順で行えばよいでしょうか？
    　Q39 コミッショニングにおいて臨床での使用可否を判定する基準などはありますか？
    　Q40 DIR のコミッショニングおよびQA は必要でしょうか？
    　Q41 他施設と同じDIR ソフトウェアを使用しているため，自施設での精度検証は
    　　　　 省略してよいでしょうか？
    　Q42 コミッショニングに利用できるデジタルファントムはありますか？
    　Q43 定期的なQA はどのように行えばよいですか？
    　Q44 DIR ソフトウェアはどのくらいの頻度でQA を行えばよいですか？
    　Q45 患者ごとのQA は必要でしょうか？
    　Q46 患者ごとのQA はどのようにすればよいですか？
    　Q47 患者ごとにDIR 精度を評価する場合，どのくらいのDIR 精度であれば
    　　　　 臨床利用できますか？
    　Q48 DIR ソフトウェアと治療計画装置や治療装置との通信において注意する点は何でしょうか？

    III　使用画像について
    　Q49 歯冠などによる金属アーチファクトの有無がDIR 精度に与える影響について教えてください．
    　Q50 体内に金属インプラントがある場合，CT やMRI においてどのような対応策がありますか？
    　Q51 腸管ガスの有無はDIR の精度に影響するかどうか教えてください．
    　Q52 CT やMRI の撮像条件がDIR 精度に与える影響について教えてください．
    　Q53 CT-CT 間DIR について，頭頸部領域でどのくらいのDIR 精度であるか
    　　　　 教えてください．また，使用において注意すべき点があれば教えてください．
    　Q54 CT-CT 間DIR について，胸部領域でどのくらいのDIR 精度であるか教えてください．
    　　　　 また，使用において注意すべき点があれば教えてください．
    　Q55 CT-CT 間DIR について，腹部領域でどのくらいのDIR 精度であるか教えてください．
    　　　　 また，使用において注意すべき点があれば教えてください．
    　Q56 CT-CT 間DIR について，骨盤領域でどのくらいのDIR 精度であるか教えてください．
    　Q57 CT-CBCT 間DIR についてどのくらいのDIR 精度であるか部位ごとに教えてください．
    　Q58 CT-MRI 間DIR についてどのくらいのDIR 精度であるか部位ごとに教えてください．
    　Q59 CT-PET 間DIR についてどのくらいのDIR 精度であるか教えてください．
    　Q60 CT 画像間のDIR で，造影効果はDIR 精度に影響を与えますか？
    　Q61 DIR でMR 画像の歪みは補正できますか？
    　Q62 DIR でMR 画像を用いた線量計算が可能ですか？
    　Q63 MRI の撮像プロトコルを変更した場合，再度コミッショニングを実施する必要はありますか？
    　Q64 MRI やPET 撮影はフラット天板を使用した方がよいのでしょうか？

    IV　自動輪郭抽出
    　Q65 自動輪郭抽出について教えてください．
    　Q66 自動輪郭抽出を使った際の時間短縮はどの程度か教えてください．
    　Q67 セグメンテーションとプロパゲーションの違いは何ですか？
    　Q68 セグメンテーションにおけるアトラスベースとモデルベースの違いについて教えてください．
    　Q69 自動輪郭抽出のシングルアトラス選択法と，マルチアトラス選択法について教えてください．
    　Q70 アトラスベースセグメンテーションには何例くらい登録しておく必要があるか教えてください．
    　Q71 AI を使った自動輪郭抽出とDIR を使った自動輪郭抽出の違いについて教えてください．
    　Q72 DIR ソフトウェアによって自動輪郭描出の精度にどのような差がありますか？
    　Q73 部位ごとに最適な自動輪郭抽出法はありますか？
    　Q74 頭部・頭頸部における自動輪郭抽出について，どのくらいの精度であるか教えてください．
    　　　　 また，臨床利用する際の注意点についても教えてください．
    　Q75 胸部における自動輪郭抽出について，どのくらいの精度であるか教えてください．
    　　　　 また，臨床利用する際の注意点についても教えてください．
    　Q76 腹部における自動輪郭抽出について，どのくらいの精度であるか教えてください．
    　　　　 また，臨床利用する際の注意点についても教えてください．
    　Q77 骨盤部における自動輪郭抽出について，どのくらいの精度であるか教えてください．
    　　　 また，臨床利用する際の注意点についても教えてください．

    V　線量の変形と合算
    　Q78 DIR を用いた線量分布変形の利用法とワークフローを教えてください．
    　Q79 線量分布変形のアルゴリズムについて教えてください．
    　Q80 DVF を基にした線量分布変形はどのくらい正確ですか？
    　Q81 線量分布合算にDIR アルゴリズムの影響はありますか？
    　Q82 DIR の誤差が線量分布変形に及ぼす影響について教えてください．
    　Q83 線量分布合算に必要なDIR 精度について，どこまでのDVF 誤差が許容されますか？
    　Q84 合算をした線量分布の評価方法にはどのようなものがありますか？
    　Q85 Inverse consistency error によるDIR を用いた線量分布変形の
    　　　　不確実性評価法について教えてください．
    　Q86 目標画像と被変形画像の選択がDIR を用いた線量合算結果に及ぼす影響について教えてください．
    　Q87 DIR を用いた合算線量分布において，評価したいDVH パラメータによって
    　　 注意すべき点は異なりますか？
    　Q88 IGRT で撮影されたCBCT 画像とDIR を用いて実際に照射された線量を評価できますか？
    　Q89 DIR を用いた線量合算が有効な部位について教えてください．
    　Q90 DIR を用いた合算線量と臨床成績には相関があるでしょうか？
    　Q91 適応放射線治療においてDIR を用いた線量分布合算は有用でしょうか？
    　Q92 照射法や照射時期が異なる場合のDIR について，どのような適応がありますか？
    　Q93 陽子線治療や重粒子線治療においてDIR による線量合算は有用でしょうか？
    　　　 　X 線治療との違いがあれば教えてください．
    　Q94 4DCT とDIR を用いた4 次元線量分布計算は呼吸性移動を考慮した
    　　　　 線量評価に有効ですか？
    　Q95 4DCT とDIR を用いた4 次元線量分布計算によりインタープレイ効果の
    　　　　 影響を考慮できますか？
    　Q96 頭頸部における線量合算の利点と欠点を教えてください．
    　Q97 胸部における線量合算の利点と欠点を教えてください．
    　Q98 腹部における線量合算の利点と欠点を教えてください．
    　Q99 骨盤部における線量合算の利点と欠点を教えてください．
    　Q100 外部照射と永久挿入密封小線源治療を併用した前立腺癌症例における
    　　　　　 DIR 利用の利点と欠点を教えてください．
    　Q101 婦人科領域においてDIR は有効でしょうか？
    　Q102 婦人科領域の小線源治療および外部照射におけるDIR で
    　　　　　 留意すべきことはありますか？
    　Q103 婦人科領域でDIR を実施した際，視覚評価で注視するべきポイントを
    　　　　　 教えてください．
    　Q104 小線源治療で使用するアプリケータのDIR に及ぼす影響とその対処法を
    　　　　　 教えてください．

    VI　適応放射線治療と再照射
    　Q105 生理的変化がDIR 精度に与える影響と対処法について教えてください．
    　Q106 DIR で撮影時の患者体位の違いを補うことはできますか？
    　Q107 再照射の治療計画においてDIR により合算線量を正しく評価できますか？
    　Q108 再照射におけるDIR を用いた合算線量評価と臨床結果との関係を
    　　　　　 教えてください．
    　Q109 再照射時のDIR を用いた治療計画法について教えてください．

    VII　その他のDIR 活用
    　Q110 DIR によって肺の換気能を画像化する（CT 肺換気画像）メカニズムを
    　　　　　 教えてください．
    　Q111 CT 肺換気画像の精度を教えてください．
    　Q112 CT 肺換気画像の利用方法を教えてください．
    　Q113 CT 肺換気画像を臨床利用する際の注意点を教えてください．
    　Q114 機能画像における利用以外で，DIR を用いた最新の研究内容について
    　　　　　 教えてください．

    DIR 機能を搭載した治療計画支援装置および治療計画装置

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I 概論

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III 使用画像について

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IV 自動輪郭抽出

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V 線量の変形と合算

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3) Yeo UA, Taylor ML, Supple JR, et al. Evaluation of dosimetric misrepresentations from 3D conventional planning of liver SBRT using 4D deformable dose integration. J Appl Clin Med Phys. 2014 ; 15 : 4978.
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2) Brock KK, Mutic S, McNutt TR, et al. Use of image registration and fusion algorithms and techniques in radiotherapy : Report of the AAPM Radiation Therapy Committee Task Group No. 132. Med Phys. 2017 ; 44 : 43-76.
 

VI 適応放射線治療と再照射

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P.239 掲載の参考文献
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2) Fukumitsu N, Nitta K, Terunuma T, et al. Registration error of the liver CT using deformable image registration of MIM Maestro and Velocity AI. BMC Med Imaging. 2017 ; 17 : 30.
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3) Senthi S, Griffioen GH, van Sornsen de Koste JR, et al. Comparing rigid and deformable dose registration for high dose thoracic re-irradiation. Radiother Oncol. 2013 ; 106 : 323-6.
PubMed
4) Lee DS, Woo JY, Kim JW, et al. Re-irradiation of hepatocellular carcinoma : clinical applicability of deformable image registration. Yonsei Med J. 2016 ; 57 : 41-9.
PubMed
5) Lee S, Kim H, Ji Y, et al. Evaluation of hepatic toxicity after repeated stereotactic body radiation therapy for recurrent hepatocellular carcinoma using deformable image registration. Sci Rep. 2018 ; 8 : 16224.
PubMed
6) Boman E, Kapanen M, Pickup L, et al. Importance of deformable image registration and biological dose summation in planning of radiotherapy retreatments. Med Dosim. 2017 ; 42 : 296-303.
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7) Chen AM, Yoshizaki T, Velez MA, et al. Tolerance of the brachial plexus to high-dose reirradiation. Int J Radiat Oncol Biol Phys. 2017 ; 98 : 83-90.
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1) 日本放射線腫瘍学会QA委員会DIRガイドラインワーキンググループ. 放射線治療における非剛体レジストレーション利用のためのガイドライン 2018年版 1版 [Internet]. 日本放射線腫瘍学会. 2018 [cited 2020.10.01]. Available from : https://www.jastro.or.jp/medicalpersonnel/guideline/dir_guideline2018.pdf
 
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3) Meijneke TR, Petit SF, Wentzler D, et al. Reirradiation and stereotactic radiotherapy for tumors in the lung : Dose summation and toxicity. Radiother Oncol. 2013 ; 107 : 423-7.
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4) Evans JD, Gomez DR, Amini A, et al. Aortic dose constraints when reirradiating thoracic tumors. Radiother Oncol. 2013 ; 106 : 327-32.
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5) McAvoy S, Ciura K, Wei C, et al. Definitive reirradiation for locoregionally recurrent non-small cell lung cancer with proton beam therapy or intensity modulated radiation therapy : Predictors of high-grade toxicity and survival outcomes. Int J Radiat Oncol Biol Phys. 2014 ; 90 : 819-27.
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6) Chen AM, Yoshizaki T, Velez MA, et al. Tolerance of the brachial plexus to high-dose reirradiation. Int J Radiat Oncol Biol Phys. 2017 ; 98 : 83-90.
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7) Lee S, Kim H, Ji Y, et al. Evaluation of hepatic toxicity after repeated stereotactic body radiation therapy for recurrent hepatocellular carcinoma using deformable image registration. Sci Rep. 2018 ; 8 : 1-9.
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8) Ren C, Ji T, Liu T, et al. The risk and predictors for severe radiation pneumonitis in lung cancer patients treated with thoracic reirradiation. Radiat Oncol. 2018 ; 13 : 1-7.
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9) Zhong H, Chetty IJ. Caution must be exercised when performing deformable dose accumulation for tumors undergoing mass changes during fractionated radiation therapy. Int J Radiat Oncol Biol Phys. 2017 ; 97 : 182-3.
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10) Chetty IJ, Rosu-Bubulac M. Deformable registration for dose accumulation. Semin Radiat Oncol. 2019 ; 29 : 198-208.
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PubMed

VII その他のDIR活用

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4) Reinhardt JM, Ding K, Cao K, et al. Registration-based estimates of local lung tissue expansion compared to xenon CT measures of specific ventilation. Med Image Anal. 2008 ; 12 : 752-63.
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