Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

Feasibility of Multiparametric Positron Emission Tomography/Magnetic Resonance Imaging as a One-Stop Shop for Radiation Therapy Planning for Patients with Head and Neck Cancer

Research output: Contribution to journalJournal articleResearchpeer-review

  1. ILROG Lymphoma Mini-Atlas Part II, Hodgkin Lymphoma

    Research output: Contribution to journalEditorialResearchpeer-review

  2. Daily Adaptive Proton Therapy: Is it Appropriate to Use Analytical Dose Calculations for Plan Adaption?

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Diminishing Returns From Ultrahypofractionated Radiation Therapy for Prostate Cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. The Feasibility of Implementing Deep Inspiration Breath-Hold for Pediatric Radiation Therapy

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

PURPOSE: Multiparametric positron emission tomography (PET)/magnetic resonance imaging (MRI) as a one-stop shop for radiation therapy (RT) planning has great potential but is technically challenging. We studied the feasibility of performing multiparametric PET/MRI of patients with head and neck cancer (HNC) in RT treatment position. As a step toward planning RT based solely on PET/MRI, a deep learning approach was employed to generate synthetic computed tomography (sCT) from MRI. This was subsequently evaluated for dose calculation and PET attenuation correction (AC).

METHODS AND MATERIALS: Eleven patients, including 3 pilot patients referred for RT of HNC, underwent PET/MRI in treatment position after a routine fluorodeoxyglucose-PET/CT planning scan. The PET/MRI scan protocol included multiparametric imaging. A convolutional neural network was trained in a leave-one-out process to predict sCT from the Dixon MRI. The clinical CT-based dose plans were recalculated on sCT, and the plans were compared in terms of relative differences in mean, maximum, near-maximum, and near-minimum absorbed doses for different volumes of interest. Comparisons between PET with sCT-based AC and PET with CT-based AC were assessed based on the relative differences in mean and maximum standardized uptake values (SUVmean and SUVmax) from the PET-positive volumes.

RESULTS: All 11 patients underwent PET/MRI in RT treatment position. Apart from the 3 pilots, full multiparametric imaging was completed in 45 minutes for 7 out of 8 patients. One patient terminated the examination after 30 minutes. With the exception of 1 patient with an inserted tracheostomy tube, all dosimetric parameters of the sCT-based dose plans were within ±1% of the CT-based dose plans. For PET, the mean difference was 0.4 ± 1.2% for SUVmean and -0.5 ± 1.0% for SUVmax.

CONCLUSIONS: Performing multiparametric PET/MRI of patients with HNC in RT treatment position was clinically feasible. The sCT generation resulted in AC of PET and dose calculations sufficiently accurate for clinical use. These results are an important step toward using multiparametric PET/MRI as a one-stop shop for personalized RT planning.

Original languageEnglish
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number5
Pages (from-to)1329-1338
Number of pages10
Publication statusPublished - 1 Dec 2020

ID: 60722159