Visualization of 4D multimodal imaging data and its applications in radiotherapy planning

• Published in: Journal of applied clinical medical physics Vol. 18; no. 6; pp. 183 - 193
• Main Authors: Schlachter, Matthias, Fechter, Tobias, Adebahr, Sonja, Schimek‐Jasch, Tanja, Nestle, Ursula, Bühler, Katja
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-11-2017; John Wiley and Sons Inc
• Subjects: 4D multimodal visualization; 4D‐PET/CT; Accuracy; Data processing; Datasets; Decision making; Four-Dimensional Computed Tomography - methods; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - radiotherapy; Movement; Multimodal Imaging - methods; Planning; Positron-Emission Tomography - methods; Quality; Radiation Oncology Physics; Radiation therapy; Radiotherapy Dosage; radiotherapy planning; Radiotherapy Planning, Computer-Assisted - methods; Radiotherapy, Intensity-Modulated - methods; Respiration; Tumors; Visualization; volume navigation; radiotherapy planning; 4D-PET/CT; 4D multimodal visualization; volume navigation
• ISSN: 1526-9914; 1526-9914
• DOI: 10.1002/acm2.12209

Purpose
To explore the benefit of using 4D multimodal visualization and interaction techniques for defined radiotherapy planning tasks over a treatment planning system used in clinical routine (C‐TPS) without dedicated 4D visualization.
Methods
We developed a 4D visualization system (4D‐VS) with dedicated rendering and fusion of 4D multimodal imaging data based on a list of requirements developed in collaboration with radiation oncologists. We conducted a user evaluation in which the benefits of our approach were evaluated in comparison to C‐TPS for three specific tasks: assessment of internal target volume (ITV) delineation, classification of tumor location in peripheral or central, and assessment of dose distribution. For all three tasks, we presented test cases for which we measured correctness, certainty, consistency followed by an additional survey regarding specific visualization features.
Results
Lower quality of the test ITVs (ground truth quality was available) was more likely to be detected using 4D‐VS. ITV ratings were more consistent in 4D‐VS and the classification of tumor location had a higher accuracy. Overall evaluation of the survey indicates 4D‐VS provides better spatial comprehensibility and simplifies the tasks which were performed during testing.
Conclusions
The use of 4D‐VS has improved the assessment of ITV delineations and classification of tumor location. The visualization features of 4D‐VS have been identified as helpful for the assessment of dose distribution during user testing.