Cargando…

Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer

BACKGROUND: Interest in MR-only treatment planning for radiation therapy is growing rapidly with the emergence of integrated MRI/linear accelerator technology. The purpose of this study was to evaluate the feasibility of using synthetic CT images generated from conventional Dixon-based MRI scans for...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Hesheng, Chandarana, Hersh, Block, Kai Tobias, Vahle, Thomas, Fenchel, Matthias, Das, Indra J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485621/
https://www.ncbi.nlm.nih.gov/pubmed/28651599
http://dx.doi.org/10.1186/s13014-017-0845-5
_version_ 1783246105633357824
author Wang, Hesheng
Chandarana, Hersh
Block, Kai Tobias
Vahle, Thomas
Fenchel, Matthias
Das, Indra J.
author_facet Wang, Hesheng
Chandarana, Hersh
Block, Kai Tobias
Vahle, Thomas
Fenchel, Matthias
Das, Indra J.
author_sort Wang, Hesheng
collection PubMed
description BACKGROUND: Interest in MR-only treatment planning for radiation therapy is growing rapidly with the emergence of integrated MRI/linear accelerator technology. The purpose of this study was to evaluate the feasibility of using synthetic CT images generated from conventional Dixon-based MRI scans for radiation treatment planning of lung cancer. METHODS: Eleven patients who underwent whole-body PET/MR imaging following a PET/CT exam were randomly selected from an ongoing prospective IRB-approved study. Attenuation maps derived from the Dixon MR Images and atlas-based method was used to create CT data (synCT). Treatment planning for radiation treatment of lung cancer was optimized on the synCT and subsequently copied to the registered CT (planCT) for dose calculation. Planning target volumes (PTVs) with three sizes and four different locations in the lung were planned for irradiation. The dose-volume metrics comparison and 3D gamma analysis were performed to assess agreement between the synCT and CT calculated dose distributions. RESULTS: Mean differences between PTV doses on synCT and CT across all the plans were −0.1% ± 0.4%, 0.1% ± 0.5%, and 0.4% ± 0.5% for D95, D98 and D100, respectively. Difference in dose between the two datasets for organs at risk (OARs) had average differences of −0.14 ± 0.07 Gy, 0.0% ± 0.1%, and −0.1% ± 0.2% for maximum spinal cord, lung V20, and heart V40 respectively. In patient groups based on tumor size and location, no significant differences were observed in the PTV and OARs dose-volume metrics (p > 0.05), except for the maximum spinal-cord dose when the target volumes were located at the lung apex (p = 0.001). Gamma analysis revealed a pass rate of 99.3% ± 1.1% for 2%/2 mm (dose difference/distance to agreement) acceptance criteria in every plan. CONCLUSIONS: The synCT generated from Dixon-based MRI allows for dose calculation of comparable accuracy to the standard CT for lung cancer treatment planning. The dosimetric agreement between synCT and CT calculated doses warrants further development of a MR-only workflow for radiotherapy of lung cancer.
format Online
Article
Text
id pubmed-5485621
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-54856212017-06-30 Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer Wang, Hesheng Chandarana, Hersh Block, Kai Tobias Vahle, Thomas Fenchel, Matthias Das, Indra J. Radiat Oncol Research BACKGROUND: Interest in MR-only treatment planning for radiation therapy is growing rapidly with the emergence of integrated MRI/linear accelerator technology. The purpose of this study was to evaluate the feasibility of using synthetic CT images generated from conventional Dixon-based MRI scans for radiation treatment planning of lung cancer. METHODS: Eleven patients who underwent whole-body PET/MR imaging following a PET/CT exam were randomly selected from an ongoing prospective IRB-approved study. Attenuation maps derived from the Dixon MR Images and atlas-based method was used to create CT data (synCT). Treatment planning for radiation treatment of lung cancer was optimized on the synCT and subsequently copied to the registered CT (planCT) for dose calculation. Planning target volumes (PTVs) with three sizes and four different locations in the lung were planned for irradiation. The dose-volume metrics comparison and 3D gamma analysis were performed to assess agreement between the synCT and CT calculated dose distributions. RESULTS: Mean differences between PTV doses on synCT and CT across all the plans were −0.1% ± 0.4%, 0.1% ± 0.5%, and 0.4% ± 0.5% for D95, D98 and D100, respectively. Difference in dose between the two datasets for organs at risk (OARs) had average differences of −0.14 ± 0.07 Gy, 0.0% ± 0.1%, and −0.1% ± 0.2% for maximum spinal cord, lung V20, and heart V40 respectively. In patient groups based on tumor size and location, no significant differences were observed in the PTV and OARs dose-volume metrics (p > 0.05), except for the maximum spinal-cord dose when the target volumes were located at the lung apex (p = 0.001). Gamma analysis revealed a pass rate of 99.3% ± 1.1% for 2%/2 mm (dose difference/distance to agreement) acceptance criteria in every plan. CONCLUSIONS: The synCT generated from Dixon-based MRI allows for dose calculation of comparable accuracy to the standard CT for lung cancer treatment planning. The dosimetric agreement between synCT and CT calculated doses warrants further development of a MR-only workflow for radiotherapy of lung cancer. BioMed Central 2017-06-26 /pmc/articles/PMC5485621/ /pubmed/28651599 http://dx.doi.org/10.1186/s13014-017-0845-5 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Wang, Hesheng
Chandarana, Hersh
Block, Kai Tobias
Vahle, Thomas
Fenchel, Matthias
Das, Indra J.
Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title_full Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title_fullStr Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title_full_unstemmed Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title_short Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer
title_sort dosimetric evaluation of synthetic ct for magnetic resonance-only based radiotherapy planning of lung cancer
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485621/
https://www.ncbi.nlm.nih.gov/pubmed/28651599
http://dx.doi.org/10.1186/s13014-017-0845-5
work_keys_str_mv AT wanghesheng dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer
AT chandaranahersh dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer
AT blockkaitobias dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer
AT vahlethomas dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer
AT fenchelmatthias dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer
AT dasindraj dosimetricevaluationofsyntheticctformagneticresonanceonlybasedradiotherapyplanningoflungcancer