Evaluation of internal target volume of abdominal tumors using cine-MRI.

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Jessica Lye, Reza Alinaghi-Zadeh, Sandie Fisher, Nikki Shelton, Glenn Cahoon, Leah McDermott, Richard Khor, Kym Rykers, Sweet Ping Ng
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引用次数: 0

Abstract

Introduction: The detailed anatomy visualization with magnetic resonance (MR)-guided radiotherapy is particularly attractive for abdominal treatments, but patient respiratory motion can compromise image quality. The "navigator technique" produces high-quality 3D images, triggered by diaphragm displacement, in exhale phase only. The gold standard for planning is 4D imaging, which visualizes the lesion for all breathing phases. When 4D imaging is not available, an alternative is using 3D imaging combined with motion information from cine-MR.

Methods: This work investigates two alternative internal target volume (ITV) generation methods and compares them with the original treatment 4DCT imaging ITV. Datasets were analyzed from 10 upper abdominal patients that originally had been treated with a 4DCT-based ITV. In addition to the 4DCT, these patients received an exhale MR and cine-MR scans prior to treatment. An MR-CT-compatible motion phantom was also used to compare the two alternative ITV methods with the clinical 4DCT method. The first ITV method uses "margins expansion" (ME method) asymmetrically. The second method duplicates the exhale gross tumor volume (GTV) and shifts it to the positions of the average inhale GTV and mid-position GTV. The ITV is the "Boolean combine" (BC method) of the three displaced GTVs. The ME and BC methods were compared with the clinical 4DCT method using the Dice similarity coefficient (DSC) to determine the impact of approximating the true GTV trajectory and neglecting deformation.

Results: The ITV DSC ranges were 73%-96% for the ME method and 76%96% for the BC method. The BC approach created smaller treatment volumes than the ME method and more closely resembled the 4DCT margin for cases with larger motion and a significant component in the anterior-posterior direction.

Conclusions: An exhale MR combined with cine-MR can be used to simply create an ITV for adaptive MR-guided radiotherapy. For small lesions with larger anterior motion, the Boolean Combine method is the more accurate method.

腹部肿瘤内靶体积的影像学评价。
磁共振(MR)引导放射治疗的详细解剖可视化对腹部治疗特别有吸引力,但患者的呼吸运动可能会影响图像质量。“导航技术”产生高质量的3D图像,由隔膜位移触发,仅在呼气阶段。规划的黄金标准是四维成像,可以在所有呼吸阶段看到病变。当4D成像不可用时,另一种选择是使用3D成像结合来自cine-MR的运动信息。方法:研究了两种不同的内部靶体积(ITV)生成方法,并将其与原始治疗的4DCT成像ITV进行了比较。数据集分析来自10名最初接受基于4dct的ITV治疗的上腹部患者。除了4DCT外,这些患者在治疗前还接受了呼气MR和电影MR扫描。同时,我们还使用核磁共振ct兼容的运动模体来比较两种可选的ITV方法与临床4DCT方法。第一种ITV方法不对称地使用“边距扩展”(ME方法)。第二种方法是复制呼气总肿瘤体积(GTV),并将其移动到平均吸入GTV和中间位置GTV的位置。ITV是三个移位gtv的“布尔组合”(BC法)。使用Dice相似系数(DSC)将ME和BC方法与临床4DCT方法进行比较,以确定近似真实GTV轨迹和忽略变形的影响。结果:ME法的ITV DSC范围为73% ~ 96%,BC法为76% ~ 96%。与ME方法相比,BC入路的治疗体积更小,对于运动较大且前后方向有重要组成部分的病例,BC入路更接近4DCT边缘。结论:呼气MR结合cine-MR可以简单地创建一个自适应MR引导放疗的ITV。对于前运动较大的小病变,布尔联合法是比较准确的方法。
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来源期刊
CiteScore
3.60
自引率
19.00%
发文量
331
审稿时长
3 months
期刊介绍: Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic
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