Physics and Imaging in Radiation Oncology · 2019 · 22 citations · 32 references
MedicineRadiation OncologyRadiologyDiagnostic ImagingDiagnostic RadiologyTreatment PlanningBrain ImagingBrain TumorsMagnetic Resonance Image ReconstructionMagnetic Resonance ImagingMedical ImagingRadiation TherapyAccuracyBrain Target DelineationImage Registration Quality AssuranceMagnetic ResonanceMagnetic Resonance Imaging-guided PlanningMagnetic Resonance-guided RadiotherapyTarget Delineation AdaptationThree-dimensional Dose Prescription
Background and purpose In neuro-oncology, high spatial accuracy is needed for clinically acceptable high-precision radiation treatment planning (RTP). In this study, the clinical applicability of anatomically optimised 7-Tesla (7T) MR images for reliable RTP is assessed with respect to standard clinical imaging modalities. Materials and methods System- and phantom-related geometrical distortion (GD) were quantified on clinically-relevant MR sequences at 7T and 3T, and on CT images using a dedicated anthropomorphic head phantom incorporating a 3D grid-structure, creating 436 points-of-interest. Global GD was assessed by mean absolute deviation (MAD Global ). Local GD relative to the magnetic isocentre was assessed by MAD Local . Using 3D displacement vectors of individual points-of-interest, GD maps were created. For clinically acceptable radiotherapy, 7T images need to meet the criteria for accurate dose delivery (GD < 1 mm) and present comparable GD as tolerated in clinically standard 3T MR/CT-based RTP. Results MAD Global in 7T and 3T images ranged from 0.3 to 2.2 mm and 0.2–0.8 mm, respectively. MAD Local increased with increasing distance from the isocentre, showed an anisotropic distribution, and was significantly larger in 7T MR sequences (MAD Local = 0.2–1.2 mm) than in 3T (MAD Local = 0.1–0.7 mm) (p < 0.05). Significant differences in GD were detected between 7T images (p < 0.001). However, maximum MAD Local remained ≤1 mm within 68.7 mm diameter spherical volume. No significant differences in GD were found between 7T and 3T protocols near the isocentre. Conclusions System- and phantom-related GD remained ≤1 mm in central brain regions, suggesting that 7T MR images could be implemented in radiotherapy with clinically acceptable spatial accuracy and equally tolerated GD as in 3T MR/CT-based RTP. For peripheral regions, GD should be incorporated in safety margins for treatment uncertainties. Moreover, the effects of sequence-related factors on GD needs further investigation to obtain RTP-specific MR protocols.
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