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Radiothérapie guidée par l'image du cancer de la prostate : vers l'intégration des déformations anatomiques

Abstract : This work deals with the quantification and the compensation of anatomical deformations during image-guided radiotherapy of prostate cancer. Firstly, we propose a population-based approach to quantify the geometrical uncertainties by means of coverage probability matrices of the target tumor during the treatment. We then propose a margins optimization method based on geometrical coverage criteria of the tumor target. This method provides rationnal margins models associated to the different geometrical uncertainties and patient repositioning protocols. Secondly, we propose a method to estimate the locally accumulated dose during the treatment. This method relies on a deformable image registration process in order to estimate the organ deformations between each treatment fraction and the planning. Different registration methods are proposed, using different level of user interactions (landmarks specification or delineations) to constrain the deformation estimation. In order to evaluate the performance of the proposed methods, we then describe the generation of a numerical phantom based on a biomechanical model. The results are presented for the numerical phantom and real clinical cases. We show that the benefit brought by the manual placement of some landmarks to constrain the registration represents a good compromise between the required interaction level and the dose estimation accuracy. Finally, we address the issue of the analysis of population data in order to better understand the relationship between the locally delivered dose and clinical effects. With deformable image registration of a population of patients on an anatomical template, regions whose dose is significantly associated with recurrence events are identified. This last part is an exploratory study aiming to better use the information carried by the entire distribution dose, and according to the cancer profile.
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  • HAL Id : tel-00992354, version 1

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Guillaume Cazoulat. Radiothérapie guidée par l'image du cancer de la prostate : vers l'intégration des déformations anatomiques. Traitement du signal et de l'image [eess.SP]. Université Rennes 1, 2013. Français. ⟨NNT : 2013REN1S158⟩. ⟨tel-00992354⟩

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