# Personalising Deformable Image Registration with Clinical Context and Deformation History for Adaptive Radiotherapy

arXiv: https://arxiv.org/abs/2610.18926 · HTML: https://mlsanity.com/paper/2610.18926/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 19 references that are in the map.
- First posted on arXiv 13 Oct 2026.

## Builds on (most cited first, 11 of 11)

- [Learning Phrase Representations using RNN Encoder-Decoder for Statistical Machine Translation](https://mlsanity.com/paper/1406.1078/) (2014)
- [FiLM: Visual Reasoning with a General Conditioning Layer](https://mlsanity.com/paper/1709.07871/) (2017)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [VoxelMorph: A Learning Framework for Deformable Medical Image Registration](https://mlsanity.com/paper/1809.05231/) (2018)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [DiffuseMorph: Unsupervised Deformable Image Registration Using Diffusion Model](https://mlsanity.com/paper/2112.05149/) (2021)
- [uniGradICON: A Foundation Model for Medical Image Registration](https://mlsanity.com/paper/2403.05780/) (2024)
- [Correlation-aware Coarse-to-fine MLPs for Deformable Medical Image Registration](https://mlsanity.com/paper/2406.00123/) (2024)
- [MambaMorph: a Mamba-based Framework for Medical MR-CT Deformable Registration](https://mlsanity.com/paper/2401.13934/) (2024)
- [TransMorph: Transformer for unsupervised medical image registration](https://mlsanity.com/paper/2111.10480/) (2021)

## Abstract (arXiv)

Adaptive radiotherapy must account for anatomical changes during treatment, but doing so depends on reliably mapping targets, organs at risk and dose across serial images. Existing registration methods treat each image pair independently, without using radiotherapy-specific context or the patient's preceding anatomical trajectory. We developed Clinical-context-Aware and Patient-adaptive Deformable Image Registration (CAP-DIR), integrating source contours, dose, clinical text and prior-registration features. We evaluated 16,361 CT examinations from 3,473 patients across four institutional cohorts and five public benchmarks. CAP-DIR increased internal-test organ-at-risk-region normalized cross-correlation from 84.76% to 96.92% relative to the strongest learning-based comparator, with low deformation folding, and remained superior across seven external cohorts. In a blinded review of 20 longitudinal cases, clinically acceptable contours increased from 45.0% to 82.5% for clinical target volumes and from 22.5% to 62.5% for organs at risk, while estimated editing time decreased. In a controlled benchmark, CAP-DIR reduced global dose-mapping error by 34.5% relative to the strongest comparator. These findings show that clinically informed, longitudinal registration can improve contour usability and dose mapping for adaptive radiotherapy.