Results of 2023 survey on the use of synthetic computed tomography for magnetic resonance Imaging-only radiotherapy: Current status and future steps

IF 3.4 Q2 ONCOLOGY
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Abstract

Background and purpose

The emergence of synthetic CT (sCT) in MR-guided radiotherapy (MRgRT) represents a significant advancement, supporting MR-only workflows and online treatment adaptation. However, the lack of consensus guidelines has led to varied practices. This study reports results from a 2023 ESTRO survey aimed at defining current practices in sCT development and use.

Materials and methods

An survey was distributed to ESTRO members, including 98 questions across four sections on sCT algorithm generation and usage. By June 2023, 100 centers participated. The survey revealed diverse clinical experiences and roles, with primary sCT use in the pelvis (60%), brain (15%), abdomen (11%), thorax (8%), and head-and-neck (6%). sCT was mostly used for conventional fractionation treatments (68%), photon SBRT (40%), and palliative cases (28%), with limited use in proton therapy (4%).

Results

Conditional GANs and GANs were the most used neural network architectures, operating mainly on 1.5 T and 3 T MRI images. Less than half used paired images for training, and only 20% performed image selection. Key MR image quality parameters included magnetic field homogeneity and spatial integrity. Half of the respondents lacked a dedicated sCT-QA program, and many did not apply sanitychecks before calculation. Selection strategies included age, weight, and metal artifacts. A strong consensus (95%) emerged for vendor neutral guidelines.

Conclusion

The survey highlights the need for expert-based, vendor-neutral guidelines to standardize sCT tools, metrics, and clinical protocols, ensuring effective sCT use in MR-guided radiotherapy.
2023 年关于使用合成计算机断层扫描进行纯磁共振成像放射治疗的调查结果:现状和未来步骤
背景和目的合成 CT(sCT)在磁共振引导放射治疗(MRgRT)中的出现代表了一项重大进步,它支持只用磁共振的工作流程和在线治疗适应性。然而,由于缺乏一致的指导原则,导致实践方法各不相同。本研究报告了 2023 年 ESTRO 调查的结果,该调查旨在确定 sCT 开发和使用的当前实践。材料和方法向 ESTRO 成员分发了一份调查表,其中包括有关 sCT 算法生成和使用的四个部分的 98 个问题。截至 2023 年 6 月,共有 100 个中心参与了调查。调查显示了不同的临床经验和作用,sCT主要用于骨盆(60%)、脑部(15%)、腹部(11%)、胸部(8%)和头颈部(6%)。sCT 主要用于常规分层治疗(68%)、光子 SBRT(40%)和姑息性病例(28%),质子治疗的使用有限(4%)。不到一半的神经网络使用成对图像进行训练,只有 20% 的神经网络进行了图像选择。关键的磁共振图像质量参数包括磁场均匀性和空间完整性。半数受访者没有专门的 sCT-QA 程序,许多人在计算前没有进行卫生检查。选择策略包括年龄、体重和金属伪影。该调查突出表明,有必要制定以专家为基础、供应商中立的指南,以规范 sCT 工具、指标和临床方案,确保在 MR 引导放射治疗中有效使用 sCT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
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