Development of age-specific population-based paediatric computational phantoms for image-based data mining and other radiotherapy applications.

Computational anatomical models have many applications in paediatric radiotherapy. Age-specific computational anatomical models were historically developed to represent average and/or healthy individuals, where cancer patients may present with anatomical variations caused by the disease and/or treatment effects. We developed RT-PAL, a library of computational age-specific voxelized anatomical models tailored to represent the paediatric radiotherapy population.Data from patients undergoing craniospinal irradiation (CSI) were used (n = 74, median age 7.3y, range: 1-17y). The RT-PAL phantoms were generated using groupwise deformable image registration to spatially normalize and average a sub-set of twenty clinical CTs and contours (n = 74, median age 7.7y, range: 3-14 y). To assess their anatomical and age-dependency plausibility, the RT-PAL models were compared against clinical cancer patient data and two healthy population based libraries of phantoms: the International Commission on Radiological Protection (ICRP) pediatric reference computational phantoms (n = 8, median age 7.5y, range: 1-15y) and a range of 4D paediatric extended cardiac torso (XCAT) phantoms (n = 75, median age 9.1y, range: 1-18y). For each dataset, nineteen organs were segmented on all age models to determine their volume. Each set was evaluated through a linear fit of organ volume with age, where comparisons were made relative to the linear fit of the clinical data.Overall good anatomical plausibility was found for the RT-PAL phantoms. The age-dependency reported was comparable to both the clinical data and other phantoms, demonstrating their efficacy as a library of age-specific phantoms. Larger discrepancies with the clinical, ICRP and XCAT organ data were attributable to differences in organ filling, segmentation strategy and age distribution of the datasets, limitations of RT-PAL generation methodology, and/or possible anatomical differences between healthy and cancer populations.The RT-PAL models showed potential in representing the paediatric radiotherapy cohort, who are most likely to benefit from dedicated, age-specific anatomical phantoms.