Clinical application of deformable image registration and auto-segmentation in radiotherapy

Sophisticated auto-segmentation and deformable image registration (DIR) toolboxes have become commercially available for clinical use in radiation oncology. A variety of clinical applications make use of both techniques. Still, their validity is not guaranteed in all circumstances and therefore one needs to be cautious when applying them in clinical use. These applications include auto-segmentation, contour propagation, re-irradiation and dose accumulation; also DIR typically plays a role in off-line and on-line plan adaptation. This NCS subcommittee aims to give an overview of literature, possibilities and pitfalls of different techniques and provide guidance to commissioning and acceptance for various clinical applications. The subcommittee officially started May 2019.

Topics to be covered

  • Overview of current auto-segmentation and DIR techniques
  • Recommendations for clinical applications of:
    • Automatic segmentation
    • Single and multi-modality DIR
    • Re-irradiation 
    • On- and Off-line plan adaptation (including contour propagation and dose accumulation)



  • Wouter van Elmpt (MAASTRO, Maastricht, Chairman,
  • Erik van Dieren (MST, Enschede, Secretary)
  • Sasha Ivashchenko (LUMC, Leiden)
  • Alexis Kotte (UMC, Utrecht)
  • Charlotte Brouwer (UMCG, Groningen)
  • Andras Zolnay (Erasmus MC, Rotterdam)
  • Peter Remeijer (NKI-AVL, Amsterdam)
  • Miguel Palacios (AUMC – VUMC, Amsterdam)
  • Jeroen van de Kamer (NKI-AVL, Amsterdam, representative of the NCS board)