Bone marrow sparing for cervical cancer radiotherapy on multimodality medical images

Abstract: Cervical cancer threatens the health of women seriously. Radiotherapy is one of the main therapy methods but with high risk of acute hematologic toxicity. Delineating the bone marrow (BM) for sparing using computer tomography (CT) images to plan before radiotherapy can effectively avoid this risk. Comparing with magnetic resonance (MR) images, CT lacks the ability to express the activity of BM. Thus, in current clinical practice, medical practitioners manually delineate the BM on CT images by corresponding to MR images. However, the time?consuming delineating BM by hand cannot guarantee the accuracy due to the inconsistency of the CT-MR multimodal images. In this study, we propose a multimodal image oriented automatic registration method for pelvic BM sparing, which consists of three-dimensional bone point cloud reconstruction, a local spherical system iteration closest point registration for marking BM on CT images. Experiments on patient dataset reveal that our proposed method can enhance the multimodal image registration accuracy and efficiency for medical practitioners in sparing BM of cervical cancer radiotherapy. The method proposed in this contribution might also provide references for similar studies in other clinical application.