SU-E-J-257: A PCA Model to Predict Adaptive Changes for Head&neck Patients Based On Extraction of Geometric Features From Daily CBCT Datasets

Purpose: Using daily cone beam CTs (CBCTs) to develop principal component analysis (PCA) models of anatomical changes in head and neck (H&N) patients and to assess the possibility of using these prospectively in adaptive radiation therapy (ART). Methods: Planning CT (pCT) images of 4 H&N patients were deformed to model several different systematic changes in patient anatomy during the course of the radiation therapy (RT). A Pinnacle plugin was used to linearly interpolate the systematic change in patient for the 35 fraction RT course and to generate a set of 35 synthetic CBCTs. Each synthetic CBCT represents the systematic change in patient anatomy for each fraction. Deformation vector fields (DVFs) were acquired between the pCT and synthetic CBCTs with random fraction-to-fraction changes were superimposed on the DVFs. A patient-specific PCA model was built using these DVFs containing systematic plus random changes. It was hypothesized that resulting eigenDVFs (EDVFs) with largest eigenvalues represent the major anatomical deformations during the course of treatment. Results: For all 4 patients, the PCA model provided different results depending on the type and size of systematic change in patient's body. PCA was more successful in capturing the systematic changes early in the treatment course when these were of a larger scale with respect to the random fraction-to-fraction changes in patient's anatomy. For smaller scale systematic changes, random changes in patient could completely "hide" the systematic change. Conclusion: The leading EDVF from the patientspecific PCA models could tentatively be identified as a major systematic change during treatment if the systematic change is large enough with respect to random fraction-to-fraction changes. Otherwise, leading EDVF could not represent systematic changes reliably. This work is expected to facilitate development of population-based PCA models that can be used to prospectively identify significant anatomical changes early in treatment. This work is supported in part by a grant from Varian Medical Systems, Palo Alto, CA