ImSimQA Client Testimonials


UF Health Cancer Center at Orlando Health

ImSimQA is a very useful tool for the commissioning and QA of deformable image registration algorithms. As DIR algorithms become more commonplace in clinics, it is imperative that clinicians understand the mechanisms and limitations of these algorithms. ImSimQA allows users to create their own deformations where the underlying deformation map is user-defined and known for every point in the image set. This allows physicists to perform more extensive testing than landmark analysis would permit, especially in homogenous regions where the anatomy may be difficult to differentiate (e.g. parotid glands). Additionally, ImSimQA overcomes the limitations of testing with physical phantoms by allowing the user to work with actual patient data.

Our research team used ImSimQA in conjunction with an in-house algorithm to create a library of ten virtual head and neck phantoms for testing the performance of multiple commercial DIR algorithms. These tools allowed for the modeling of head rotation and translation, mandible rotation, spine flexion, shoulder movement, hyoid movement, tumor/node shrinkage, weight loss, and parotid shrinkage in a clinically-relevant fashion.

Jason Pukala, PhD, Physicist

UF Health Cancer Center at Orlando Health, April 2017



Minneapolis Radiation Oncology

Image Guided Radiation Therapy (IGRT) using daily kilovoltage Cone beam CT (kvCBCT) or Megavoltage CT (MVCT) imaging is emerging as the standard of care in Radiation Oncology. The technology, workflow, and clinical implementation have been on the fast track for the past year at most centers in USA.

One of the key components in IGRT workflow is the direct imaging of soft tissue and comparison with the treatment planning CT image to derive the shift of the day. This is being routinely done in most clinical institutions using a vendor supplied rigid registration auto-fusion algorithm. However, very little quality assurance has been carried out to validate this process and its accuracy in clinical work flow.

I have been using IMSIMQA for the last 4 months in both clinical and research environments. It provides excellent tools to explore the validity of registration algorithms used in IGRT work flow. Specifically, it eliminates the need to use real phantoms since actual patient images and a library of supplied phantoms can be imported and used to test the image fusion registration accuracy.

I have been particularly impressed with the IMSIMQA software’s potential to evaluate the validity and accuracy of deformable registration algorithms. Deformable registration is the key technology or process to implement adaptive radiotherapy and 4D planning because one is interested in the total dose delivered over several fractions that incorporate different patient images (adaptive) or different time points (4D). There have been numerous publications in the literature describing various algorithms on deformable registration but very few papers have addressed the validity and accuracy of the algorithms to verify that the deformations produced are indeed correct. The problem arises from the absence of a gold standard on how this can be implemented. It is clear that building a deformable phantom is an enormous challenge for most clinical departments.

IMSIMQA software has tremendous potential for evaluating the deformable registration algorithm used against a known applied deformation. The software has tools to allow the user to apply known deformations on a patient DICOM studyset thereby replicating a clinical scenario and then applying the deformable registration algorithm to evaluate what you recover after the deformation.

We are currently working towards the development of a framework within which IMSIMQA tools can be used to validate deformable registration algorithms. We believe IMSIMQA is a powerful software with applications in both clinical and research settings.

Raj Varadhan M.S.,M.Phil,D.A.B.M.P. , Senior Medical Physicist

Minneapolis Radiation Oncology, April 2011



Northampton General Hospital

ImSimQA has been in use at Northampton General Hospital for over three years. It has been an incredibly useful tool with many applications.

We originally procured it because we had acquired new Virtual Simulation software, and needed a way of commissioning and comparing the two image fusion packages we now had available. As with most departments, there is a distinct lack of time available on MR / PET scanner; and ImSimQA seemed an inspired idea! We were able to assess the advantages and limitations of each system in a controlled and methodical way; for each algorithm provided by the two systems. Following software upgrades we were able to easily re-test the planning systems.

Additional uses have been in training staff in the image fusion packages; and setting new scanning protocols in the diagnostic department to improve the chances of a successful fusion of images.

We have also been able to use it for other departmental development. For example, the advancement of breast planning, by showing the effect on a treatment plan of putting patients on lower wedge angles on breast boards.

ImSimQA is such an exceptionally valuable tool. We could not have implemented image fusion at NGH without it; and there have also been unforeseen advantages as shown above. We look forward to using it to commission respiratory gating, CT-PET fusion and other new developments in the future – all of which will be a lot less time consuming via ImSimQA.

Nicky Whilde, Head of Radiotherapy Physics

Northampton General Hospital

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