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A criterion for the reliable use of MRI-only radiotherapy

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@article{cc7419e7742646228e61149a8dfcca67,
title = "A criterion for the reliable use of MRI-only radiotherapy",
abstract = "BACKGROUND: MRI-only radiotherapy will eliminate the systematic registration errors introduced when transferring MRI information to the CT. However, challenges concerning the missing information on electron density, necessary for dose calculation and patient setup on bony anatomy are introduced. This study presents a possible statistical approach to evaluate, if deviations based on MRI-only radiotherapy as compared to the CT based radiotherapy are acceptable.METHODS: 18 head-and-neck, 21 prostate, 10 vesica and 8 pelvic patients were included in the study. Data from each patient contained a CT and a T2-weighted MRI scan, a structure set and a clinically approved CT based treatment plan, which was re-calculated with identical parameters on the density corrected MRI scans. A statistical analysis including a 95% confidence interval was performed in clinically relevant DVH points.RESULTS: The mean differences in the investigated DVH points were in the order of 1.5% for the PTV and up to 4.2% for organs at risk. In addition, a proposed criterion of 2% dose difference in the PTV coverage for 95% of the patients was fulfilled for all diagnostic groups for a bulk segmented MRI in the DVH points, D(median) and D2%, while only head-and-neck and prostate further fulfilled the criterion in D98%.CONCLUSION: Here, we suggested a method for establishing a reliable use of MRI-only radiotherapy. A population-based study comparing CT based dose calculations with those obtained on a suggested segmentation of MRI should be initiated and acceptable deviations in clinically relevant DVH points should be established. Such a population-based approach could form a part of the clinical commissioning of MRI-only radiotherapy.",
keywords = "Adult, Aged, Aged, 80 and over, Female, Head and Neck Neoplasms, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pelvic Neoplasms, Prostatic Neoplasms, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Image-Guided, Reproducibility of Results, Urinary Bladder Neoplasms",
author = "Korsholm, {Marie E} and Waring, {Line W} and Edmund, {Jens M}",
year = "2014",
doi = "10.1186/1748-717X-9-16",
language = "English",
volume = "9",
pages = "16",
journal = "Radiation Oncology",
issn = "1748-717X",
publisher = "BioMed Central Ltd",

}

RIS

TY - JOUR

T1 - A criterion for the reliable use of MRI-only radiotherapy

AU - Korsholm, Marie E

AU - Waring, Line W

AU - Edmund, Jens M

PY - 2014

Y1 - 2014

N2 - BACKGROUND: MRI-only radiotherapy will eliminate the systematic registration errors introduced when transferring MRI information to the CT. However, challenges concerning the missing information on electron density, necessary for dose calculation and patient setup on bony anatomy are introduced. This study presents a possible statistical approach to evaluate, if deviations based on MRI-only radiotherapy as compared to the CT based radiotherapy are acceptable.METHODS: 18 head-and-neck, 21 prostate, 10 vesica and 8 pelvic patients were included in the study. Data from each patient contained a CT and a T2-weighted MRI scan, a structure set and a clinically approved CT based treatment plan, which was re-calculated with identical parameters on the density corrected MRI scans. A statistical analysis including a 95% confidence interval was performed in clinically relevant DVH points.RESULTS: The mean differences in the investigated DVH points were in the order of 1.5% for the PTV and up to 4.2% for organs at risk. In addition, a proposed criterion of 2% dose difference in the PTV coverage for 95% of the patients was fulfilled for all diagnostic groups for a bulk segmented MRI in the DVH points, D(median) and D2%, while only head-and-neck and prostate further fulfilled the criterion in D98%.CONCLUSION: Here, we suggested a method for establishing a reliable use of MRI-only radiotherapy. A population-based study comparing CT based dose calculations with those obtained on a suggested segmentation of MRI should be initiated and acceptable deviations in clinically relevant DVH points should be established. Such a population-based approach could form a part of the clinical commissioning of MRI-only radiotherapy.

AB - BACKGROUND: MRI-only radiotherapy will eliminate the systematic registration errors introduced when transferring MRI information to the CT. However, challenges concerning the missing information on electron density, necessary for dose calculation and patient setup on bony anatomy are introduced. This study presents a possible statistical approach to evaluate, if deviations based on MRI-only radiotherapy as compared to the CT based radiotherapy are acceptable.METHODS: 18 head-and-neck, 21 prostate, 10 vesica and 8 pelvic patients were included in the study. Data from each patient contained a CT and a T2-weighted MRI scan, a structure set and a clinically approved CT based treatment plan, which was re-calculated with identical parameters on the density corrected MRI scans. A statistical analysis including a 95% confidence interval was performed in clinically relevant DVH points.RESULTS: The mean differences in the investigated DVH points were in the order of 1.5% for the PTV and up to 4.2% for organs at risk. In addition, a proposed criterion of 2% dose difference in the PTV coverage for 95% of the patients was fulfilled for all diagnostic groups for a bulk segmented MRI in the DVH points, D(median) and D2%, while only head-and-neck and prostate further fulfilled the criterion in D98%.CONCLUSION: Here, we suggested a method for establishing a reliable use of MRI-only radiotherapy. A population-based study comparing CT based dose calculations with those obtained on a suggested segmentation of MRI should be initiated and acceptable deviations in clinically relevant DVH points should be established. Such a population-based approach could form a part of the clinical commissioning of MRI-only radiotherapy.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Head and Neck Neoplasms

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Pelvic Neoplasms

KW - Prostatic Neoplasms

KW - Radiotherapy Planning, Computer-Assisted

KW - Radiotherapy, Image-Guided

KW - Reproducibility of Results

KW - Urinary Bladder Neoplasms

U2 - 10.1186/1748-717X-9-16

DO - 10.1186/1748-717X-9-16

M3 - Journal article

C2 - 24405515

VL - 9

SP - 16

JO - Radiation Oncology

JF - Radiation Oncology

SN - 1748-717X

ER -

ID: 45442987