1. Optimisation and validation of an integrated magnetic resonance imaging-only radiotherapy planning solution
- Author
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Jae H. Choi, Kate Skehan, Jason Dowling, Helen Warren-Forward, Laura M. O'Connor, Peter B. Greer, Jarad Martin, and John Simpson
- Subjects
Dose-volume histogram ,medicine.medical_treatment ,MRI only radiation therapy ,R895-920 ,Medical physics. Medical radiology. Nuclear medicine ,Medicine ,Dosimetry ,sCT, synthetic computed tomography ,Radiology, Nuclear Medicine and imaging ,Pelvic Neoplasms ,Original Research Article ,Rectal cancer ,Radiation treatment planning ,ICRU, International Commission on Radiation Units and Measurements ,Synthetic CT ,RC254-282 ,Radiation ,Prostate cancer ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Dose comparison ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Magnetic resonance imaging ,Pelvic cancer ,HU, Hounsfield Unit ,Radiation therapy ,DVH, dose volume histogram ,Radiation therapy treatment planning ,business ,Nuclear medicine ,RED, Relative electron density - Abstract
Background and purpose Magnetic resonance imaging (MRI)-only treatment planning is gaining in popularity in radiation oncology, with various methods available to generate a synthetic computed tomography (sCT) for this purpose. The aim of this study was to validate a sCT generation software for MRI-only radiotherapy planning of male and female pelvic cancers. The secondary aim of this study was to improve dose agreement by applying a derived relative electron and mass density (RED) curve to the sCT. Method and materials Computed tomography (CT) and MRI scans of forty patients with pelvic neoplasms were used in the study. Treatment plans were copied from the CT scan to the sCT scan for dose comparison. Dose difference at reference point, 3D gamma comparison and dose volume histogram analysis was used to validate the dose impact of the sCT. The RED values were optimised to improve dose agreement by using a linear plot. Results The average percentage dose difference at isocentre was 1.2% and the mean 3D gamma comparison with a criteria of 1%/1 mm was 84.0% ± 9.7%. The results indicate an inherent systematic difference in the dosimetry of the sCT plans, deriving from the tissue densities. With the adapted REDmod table, the average percentage dose difference was reduced to −0.1% and the mean 3D gamma analysis improved to 92.9% ± 5.7% at 1%/1 mm. Conclusions CT generation software is a viable solution for MRI-only radiotherapy planning. The option makes it relatively easy for departments to implement a MRI-only planning workflow for cancers of male and female pelvic anatomy.
- Published
- 2021