A practical probabilistic framework for deformable image registration uncertainty in radiotherapy dose propagation

• URL: http://arxiv.org/abs/2606.09253v1
• Date: Mon, 08 Jun 2026 09:25:04 GMT
• Title: A practical probabilistic framework for deformable image registration uncertainty in radiotherapy dose propagation
• Abstract summary: Deformable image registration (DIR) is widely used in radiotherapy for dose propagation and accumulation.<n>Uncertainty in the underlying deformation can substantially affect clinically relevant dose estimates.<n>We present a practical probabilistic framework for propagating DIR uncertainty to dose statistics and dose-volume histograms.
• Score: 0.08335944622646994
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: Deformable image registration (DIR) is widely used in radiotherapy for dose propagation and accumulation, but uncertainty in the underlying deformation can substantially affect clinically relevant dose estimates. We present a practical probabilistic framework for propagating DIR uncertainty to voxel-wise dose statistics and dose-volume histograms (DVHs). The method models the mapped correspondence at each voxel as a random variable governed by a transparent local certainty map that can be defined by simple safety margins, structure-boundary mismatch, or structure-wise conservative uncertainty values. This yields interpretable quantities such as dose probabilities, expected dose, confidence bounds, and induced DVH envelopes. The framework is designed to remain lightweight and interpretable: it avoids complex biomechanical or ensemble-based uncertainty models and instead emphasizes simple parameterization, computational feasibility, and transparent dose metrics. We further introduce a structure-guided in/out strategy as an optional refinement that restricts mapping probabilities to anatomically plausible target regions. The approach is demonstrated on a prostate radiotherapy case study and used to compare different certainty-map strategies and probability kernels. The experiments show that the certainty-map design has a stronger effect on resulting dose and DVH uncertainty bounds than the specific kernel choice, while the additional benefit of the in/out strategy is case-dependent and modest in the present example. Overall, the proposed framework provides a transparent way to incorporate DIR uncertainty into radiotherapy dose assessment and to study how modelling choices affect propagated dose metrics.

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