Evaluation of the correlation between prostatic displacement and rectal deformation using the Dice similarity coefficient of the rectum

To estimate the relationship between the three-dimensional (3D) displacement error of the prostate and rectal deformation for reduction of deviation between the planned and treatment dose, using multiple acquisition planning CT (MPCT) and the Dice similarity coefficient (DSC) for rectal deformation for treatment of patients with prostate cancer. The 3D displacement error between the pelvic bone and a matching fiducial marker was calculated using MPCT in 24 patients who underwent prostate volumetric-modulated arc therapy for prostate cancer. We calculated the 3D displacement error between the pelvic bone and a matching fiducial marker on MPCT. The correlation of the 3D displacement error with the DSC of the rectum, calculated from MPCT images, was evaluated based on deformable image registration. The 3D displacement error of the prostate showed a slight correlation between MPCT and cone-beam computed tomography (adjusted r² = 0.241). The 3D displacement error, based on the pelvic bone and a fiducial marker on MPCT images, showed a moderate correlation with the DSC of the rectum (adjusted r² = 0.645) and was improved by a mean of 3.94 mm, based on MPCT, during the treatment period. The 3D displacement error on MPCT correlates with the 3D displacement error of daily cone-beam computed tomography; optimal selection of MPCT can potentially facilitate on-board setup of prostate patients to enable more accurate radiotherapy. The advance information of the 3D displacement error and rectal deformation is useful for optimal planning CT that can minimize the deviation between the planned dose and the treatment dose in patients receiving treatment for prostate cancer.