Registration by interactive inverse simulation: application for adaptive radiotherapy.

PURPOSE: This paper introduces a new methodology for semi-automatic registration of anatomical structure deformations. The contribution is to use an interactive inverse simulation of physics-based deformable model, computed in real time. METHODS: The method relies on nonlinear finite element method (FEM) within a constraint-based framework. Given a set of few registered points provided by the user, a real-time optimization adapts the boundary conditions and(/or) some parameters of the FEM in order to obtain the adequate geometrical deformations. To dramatically fasten the process, the method relies on a projection of the model in the space of the optimization variables. In this reduced space, a quadratic programming problem is formulated and solved very quickly. The method is validated with numerical examples for retrieving some unknown parameters such as the Young's modulus and some pressures on the boundaries of the model. RESULTS: The approach is employed in the context of radiotherapy of the neck where weight loss during the 7 weeks of the therapy modifies the volume of the anatomical structures and induces large deformations. Indeed, sensitive structures such as the parotid glands may cross the target volume due to these deformations which leads to adverse effects for the patient. We thus apply the approach for the registration of the parotid glands during the radiotherapy of the head and neck cancer. CONCLUSIONS: The results show how the method could be used in a clinical routine and be employed in the planning in order to limit the radiations of these glands.

Introducing interactive inverse FEM simulation and its application for adaptive radiotherapy.

We introduce a new methodology for semi-automatic deformable registration of anatomical structures, using interactive inverse simulations. The method relies on non-linear real-time Finite Element Method (FEM) within a constraint-based framework. Given a set of few registered points provided by the user, a real-time optimization adapts the boundary conditions and(/or) some parameters of the FEM in order to obtain the adequate geometrical deformations. To dramatically fasten the process, the method relies on a projection of the model in the space of the optimization variables. In this reduced space, a quadratic programming problem is formulated and solved very quickly. The method is validated with numerical examples for retrieving Young's modulus and some pressures on the boundaries. Then, we apply the approach for the registration of the parotid glands during the radiotherapy of the head and neck cancer. Radiotherapy treatment induces weight loss that modifies the shape and the positions of these structures and they eventually intersect the target volume. We show how we could adapt the planning to limit the radiation of these glands.