Evaluation of MRI-only based online adaptive radiotherapy of abdominal region on MR-linac

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Dokumenter

  • Fulltext

    Forlagets udgivne version, 1,51 MB, PDF-dokument

  • Katri Nousiainen
  • Grichar Valdes Santurio
  • Nils Lundahl
  • Rickard Cronholm
  • Carl Siversson
  • Jens M. Edmund

Purpose: A hybrid magnetic resonance linear accelerator (MRL) can perform magnetic resonance imaging (MRI) with high soft-tissue contrast to be used for online adaptive radiotherapy (oART). To obtain electron densities needed for the oART dose calculation, a computed tomography (CT) is often deformably registered to MRI. Our aim was to evaluate an MRI-only based synthetic CT (sCT) generation as an alternative to the deformed CT (dCT)-based oART in the abdominal region. Methods: The study data consisted of 57 patients who were treated on a 0.35 T MRL system mainly for abdominal tumors. Simulation MRI-CT pairs of 43 patients were used for training and validation of a prototype convolutional neural network sCT-generation algorithm, based on HighRes3DNet, for the abdominal region. For remaining test patients, sCT images were produced from simulation MRIs and daily MRIs. The dCT-based plans were re-calculated on sCT with identical calculation parameters. The sCT and dCT were compared in terms of geometric agreement and calculated dose. Results: The mean and one standard deviation of the geometric agreement metrics over dCT–sCT-pairs were: mean error of 8 ± 10 HU, mean absolute error of 49 ± 10 HU, and Dice similarity coefficient of 55 ± 12%, 60 ± 5%, and 82 ± 15% for bone, fat, and lung tissues, respectively. The dose differences between the sCT and dCT-based dose for planning target volumes were 0.5 ± 0.9%, 0.6 ± 0.8%, and 0.5 ± 0.8% at D2%, D50%, and D98% in physical dose and 0.8 ± 1.4%, 0.8 ± 1.2%, and 0.6 ± 1.1% in biologically effective dose (BED). For organs-at-risk, the dose differences of all evaluated dose–volume histogram points were within [–4.5%, 7.8%] and [–1.1 Gy, 3.5 Gy] in both physical dose and BED. Conclusions: The geometric agreement metrics were within typically reported values and most average relative dose differences were within 1%. Thus, an MRI-only sCT-based approach is a promising alternative to the current clinical practice of the abdominal oART on MRL.

OriginalsprogEngelsk
Artikelnummere13838
TidsskriftJournal of Applied Clinical Medical Physics
Vol/bind24
Udgave nummer3
Antal sider12
ISSN1526-9914
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Katri Nousiainen would like to thank the Doctoral Program in Materials Research and Nanoscience (MATRENA) of the University of Helsinki for funding the research visit at Herlev and Gentofte Hospital. We are also grateful to DSc Juha Peltonen for his comments on our manuscript.

Publisher Copyright:
© 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.

ID: 344717032