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Caroline Lafond

Publications and source records attributed to Caroline Lafond.

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An Uncertainty Estimation Framework for Dose Accumulation in Adaptive Radiotherapy: Application to CBCT-Guided Radiotherapy for Cervical Cancer

Background and purpose: oART enables daily plan adaptation to interfraction anatomical variations, but cumulative dose estimation remains limited by DIR, segmentation, and anatomical uncertainties. We introduce IMPACT-DoseAcc, an uncertainty-aware dose accumulation framework, within IMPACT for semantic feature-driven image analysis. The framework is modality- and disease-agnostic and is applied to CBCT-guided oART for cervical cancer (LACC). Material and Methods: Nine LACC patients were retrospectively analyzed using daily CBCT-derived virtual CTs for dose recalculation. IMPACT-DoseAcc focuses on uncertainty from DIR, without modeling vCT-generation uncertainty. Two DIR uncertainty strategies were tested within IMPACT-Reg: a Bayesian segmentation-guided approach using one probabilistic model to quantify anatomical uncertainty, and an ensemble of segmentation models targeting structures to capture epistemic variability. Voxel-wise uncertainty maps were propagated through dose warping and accumulation to generate probabilistic dose-volume histograms. Ensemble uncertainty was quantified from voxel-wise standard deviation across deformation fields, and geometric error was assessed using surface distance between warped and validated contours. Anatomical-variability weighting refined aggregation. Results: Ensemble DIR uncertainty correlated with geometric error, with Pearson coefficients of 0.63 for CTVt and 0.66 for bladder. For CTVt, pDVHs achieved 96.3 +/- 3.9% coverage, showing calibration of propagated uncertainty. Weighting stabilized estimates across fractions and organs. Conclusions: IMPACT-DoseAcc propagates registration-driven uncertainty to cumulative dose metrics, improving interpretation of accumulated dose under anatomical variations. Its 3DSlicer integration supports reproducible, uncertainty-informed ART workflows.

cs.CV

IMPACT: A Generic Semantic Loss for Multimodal Medical Image Registration

Image registration is fundamental in medical imaging, enabling precise alignment of anatomical structures for diagnosis, treatment planning, image-guided interventions, and longitudinal monitoring. This work introduces IMPACT (Image Metric with Pretrained model-Agnostic Comparison for Transmodality registration), a novel similarity metric designed for robust multimodal image registration. Rather than relying on raw intensities, handcrafted descriptors, or task-specific training, IMPACT defines a semantic similarity measure based on the comparison of deep features extracted from large-scale pretrained segmentation models. By leveraging representations from models such as TotalSegmentator, Segment Anything (SAM), and other foundation networks, IMPACT provides a task-agnostic, training-free solution that generalizes across imaging modalities. These features, originally trained for segmentation, offer strong spatial correspondence and semantic alignment capabilities, making them naturally suited for registration. The method integrates seamlessly into both algorithmic (Elastix) and learning-based (VoxelMorph) frameworks, leveraging the strengths of each. IMPACT was evaluated on five challenging 3D registration tasks involving thoracic CT/CBCT and pelvic MR/CT datasets. Quantitative metrics, including Target Registration Error and Dice Similarity Coefficient, demonstrated consistent improvements in anatomical alignment over baseline methods. Qualitative analyses further highlighted the robustness of the proposed metric in the presence of noise, artifacts, and modality variations. With its versatility, efficiency, and strong performance across diverse tasks, IMPACT offers a powerful solution for advancing multimodal image registration in both clinical and research settings.

cs.CV