Practical and technical key challenges in head and neck adaptive radiotherapy: The GORTEC point of view

Nolwenn Delaby (1, 2) , Anaïs Barateau , Sophie Chiavassa (3) , Marie-Claude Biston (4, 5) , Philippe Chartier , Eliane Graulières , Lucie Guinement , Sandrine Huger (6) , Thomas Lacornerie (7) , Corinne Millardet-Martin , Alain Sottiaux , Jérôme Caron (8) , David Gensanne (9, 10) , Yoann Pointreau (11) , Alexandre Coutte (12, 13) , Julian Biau (14) , Anne-Agathe Serre , Joel Castelli (1, 2) , Milan Tomsej (15) , Robin Garcia (16) , Catherine Khamphan , Aurélien Badey

1 LTSI - Laboratoire Traitement du Signal et de l'Image
2 CRLCC - CRLCC Eugène Marquis
3 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
4 Imagerie Tomographique et Radiothérapie
5 Centre Léon Bérard [Lyon]
6 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
7 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
8 Physiopathogénèse et Traitement des Maladies du Foie
9 QuantIF-LITIS - Equipe Quantification en Imagerie Fonctionnelle
10 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
11 Centre Jean Bernard [Institut Inter-régional de Cancérologie - Le Mans]
12 CHU Amiens-Picardie
13 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
14 IMoST - Imagerie Moléculaire et Stratégies Théranostiques
15 CHU de Charleroi
16 Institut Sainte Catherine [Avignon]

Anatomical variations occur during head and neck (H&N) radiotherapy (RT) treatment. These variations may result in underdosage to the target volume or overdosage to the organ at risk. Replanning during the treatment course can be triggered to overcome this issue. Due to technological, methodological and clinical evolutions, tools for adaptive RT (ART) are becoming increasingly sophisticated. The aim of this paper is to give an overview of the key steps of an H&N ART workflow and tools from the point of view of a group of French-speaking medical physicists and physicians (from GORTEC). Focuses are made on image registration, segmentation, estimation of the delivered dose of the day, workflow and quality assurance for an implementation of H&N offline and online ART. Practical recommendations are given to assist physicians and medical physicists in a clinical workflow.

Mots clés: Adaptive radiotherapy; Automatic segmentation; Dose accumulation; Head and neck cancer; Image registration; Quality assurance; Workflow

Domaines: Médecine humaine et pathologie

Nolwenn Delaby, Anaïs Barateau, Sophie Chiavassa, Marie-Claude Biston, Philippe Chartier, et al.. Practical and technical key challenges in head and neck adaptive radiotherapy: The GORTEC point of view. Physica Medica, 2023, 109, pp.102568. ⟨10.1016/j.ejmp.2023.102568⟩. ⟨hal-04061410⟩