Michael J. Dubec , Michael Berks , James Price , Lisa McDaid , John Gaffney , Ross A. Little , Susan Cheung , Marcel van Herk , Ananya Choudhury , Julian C. Matthews , Andrew McPartlin , Geoff J.M. Parker , David L. Buckley , James P.B. O’Connor
{"title":"Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer","authors":"Michael J. Dubec , Michael Berks , James Price , Lisa McDaid , John Gaffney , Ross A. Little , Susan Cheung , Marcel van Herk , Ananya Choudhury , Julian C. Matthews , Andrew McPartlin , Geoff J.M. Parker , David L. Buckley , James P.B. O’Connor","doi":"10.1016/j.phro.2024.100689","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><div>Magnetic resonance imaging – linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.5 T MRI-linac in patients with head and neck cancer (HNC) and measured biomarker repeatability and sensitivity to radiotherapy effects.</div></div><div><h3>Materials and methods</h3><div>Patients were imaged on a 1.5 T MRI-linac or a 1.5 T diagnostic MR system twice before treatment. DCE-MRI parameters including K<sup>trans</sup> were calculated, with the optimum pharmacokinetic model identified using corrected Akaike information criterion. Repeatability was assessed by within-subject coefficient of variation (wCV). Treatment effects were assessed as change measured at week 2 of radiotherapy.</div></div><div><h3>Results</h3><div>14 patients were recruited (6 scanned on diagnostic MR and 8 on MRI-linac), with a total of 24 lesions. Baseline K<sup>trans</sup> estimates were comparable on both MR systems; 0.13 [95 %CI: 0.10 to 0.16] min<sup>−1</sup> (diagnostic MR) and 0.15 [0.12 to 0.18] min<sup>−1</sup> (MRI-linac). wCV values were 22.6 % [95 % CI: 16.2 to 37.3 %] (diagnostic MR) and 11.7 % [8.4 to 19.3 %] (MRI-linac). Combined cohort increase in K<sup>trans</sup> was significant (p < 0.01). Similar results were seen for other DCE-MRI parameters.</div></div><div><h3>Conclusions</h3><div>DCE-MRI is feasible on a 1.5 T MRI-linac system in patients with HNC. Parameter estimates, repeatability, and sensitivity to treatment were similar to those measured on a conventional diagnostic MR system. These data support performing DCE-MRI in studies on the MRI-linac to assess treatment response and adaptive guidance based on tumour perfusion.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100689"},"PeriodicalIF":3.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721217/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physics and Imaging in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405631624001593","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and purpose
Magnetic resonance imaging – linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.5 T MRI-linac in patients with head and neck cancer (HNC) and measured biomarker repeatability and sensitivity to radiotherapy effects.
Materials and methods
Patients were imaged on a 1.5 T MRI-linac or a 1.5 T diagnostic MR system twice before treatment. DCE-MRI parameters including Ktrans were calculated, with the optimum pharmacokinetic model identified using corrected Akaike information criterion. Repeatability was assessed by within-subject coefficient of variation (wCV). Treatment effects were assessed as change measured at week 2 of radiotherapy.
Results
14 patients were recruited (6 scanned on diagnostic MR and 8 on MRI-linac), with a total of 24 lesions. Baseline Ktrans estimates were comparable on both MR systems; 0.13 [95 %CI: 0.10 to 0.16] min−1 (diagnostic MR) and 0.15 [0.12 to 0.18] min−1 (MRI-linac). wCV values were 22.6 % [95 % CI: 16.2 to 37.3 %] (diagnostic MR) and 11.7 % [8.4 to 19.3 %] (MRI-linac). Combined cohort increase in Ktrans was significant (p < 0.01). Similar results were seen for other DCE-MRI parameters.
Conclusions
DCE-MRI is feasible on a 1.5 T MRI-linac system in patients with HNC. Parameter estimates, repeatability, and sensitivity to treatment were similar to those measured on a conventional diagnostic MR system. These data support performing DCE-MRI in studies on the MRI-linac to assess treatment response and adaptive guidance based on tumour perfusion.