Evaluation of a novel quantitative multiparametric MR sequence for radiation therapy treatment response assessment

IF 2.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2025-10-07 DOI:10.1002/acm2.70274

Yuhao Yan, R. Adam Bayliss, Adam R. Burr, Andrew M. Baschnagel, Brett A. Morris, Florian Wiesinger, Jose de Arcos Rodriguez, Carri K. Glide-Hurst

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引用次数: 0

Abstract

Background

Multiparametric MRI has shown great promise to derive multiple quantitative imaging biomarkers for treatment response assessment.

Purpose

To evaluate a novel deep-learning-enhanced MUlti-PArametric MR sequence (DL-MUPA) for treatment response assessment for brain metastases patients treated with stereotactic radiosurgery (SRS) and head-and-neck (HN) cancer patients undergoing conventionally fractionation adaptive radiation therapy.

Methods

DL-MUPA derives quantitative T1 and T2 relaxation time maps from a single 4–6-min scan denoised via DL method using least-squares dictionary fitting. Longitudinal phantom benchmarking was performed on a NIST-ISMRM phantom over 1 year. In patients, longitudinal DL-MUPA data were acquired on a 1.5T MR-simulator, including pretreatment (PreTx) and every ∼3 months after SRS (PostTx) in brain, and PreTx, mid-treatment and 3 months PostTx in HN. Delta analysis was performed calculating changes of mean T1 and T2 values within gross tumor volumes (GTVs), residual disease (RD, HN), parotids, and submandibular glands (HN) for treatment response assessment. Uninvolved normal tissues (normal appearing white matter in brain, masseter in HN) were evaluated for within-subject repeatability.

Results

Phantom benchmarking revealed excellent inter-session repeatability (coefficient of variation < 0.9% for T1, < 6.6% for T2), suggesting reliability for longitudinal studies with systematic bias adjustment. Uninvolved normal tissue suggested acceptable within-subject repeatability in the brain |ΔT1_mean| < 36 ms (4.9%), |ΔT2_mean| < 2 ms (6.1%) and HN |ΔT1_mean| < 69 ms (7.0%), |ΔT2_mean| < 4 ms (17.8%) with few outliers. In brain, remarkable changes were noted in a resolved metastasis (4-month PostTx ΔT1_mean= 155 ms (13.7%)) and necrotic settings (ΔT1_mean= 214-502 ms (17.6-39.7%), ΔT2_mean= 7-41 ms (8.7-41.4%), 6-month to 3-month PostTx). In HN, two base of tongue tumors exhibited T2 enhancement (PostTx GTV ΔT2_mean> 7 ms (12.8%), RD ΔT2_mean> 10 ms (18.1%)). A case with nodal disease resolved PostTx (GTV ΔT1_mean= -541 ms (-39.5%), ΔT2_mean= -24 ms (-32.7%), RD ΔT1_mean= -400 ms (-29.2%), ΔT2_mean= -25 ms (-35.3%)). Parotids (PostTx ΔT1_mean> 82 ms (12.4%), ΔT2_mean> 6 ms (13.4%)) and submandibular glands (PostTx ΔT1_mean> 135 ms (14.6%), ΔT2_mean> 17 ms (34.5%)) adjacent to gross disease exhibited enhancement while distant organs remained stable.

Conclusions

Preliminary results suggest promise of DL-MUPA for treatment response assessment and highlight potential endpoints for functional sparing.

Abstract Image

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评价一种新的定量多参数磁共振序列用于放射治疗治疗反应评估。

背景：多参数MRI显示出巨大的希望，可以获得用于治疗反应评估的多种定量成像生物标志物。目的：评估一种新的深度学习增强多参数磁共振序列（DL-MUPA）用于评估脑转移患者接受立体定向放射手术（SRS）和头颈癌（HN）患者接受常规分步适应性放射治疗的治疗反应。方法：DL- mupa从单个4-6分钟扫描中获得定量的T1和T2弛豫时间图，通过DL方法使用最小二乘字典拟合进行降噪。在NIST-ISMRM假体上进行纵向假体基准测试超过1年。在患者中，在1.5T磁共振模拟器上获得纵向DL-MUPA数据，包括预处理（prex）和脑SRS （PostTx）后每~ 3个月，以及HN的prex，治疗中期和3个月PostTx。进行Delta分析，计算总肿瘤体积（gtv）、残留病变（RD、HN）、腮腺和下颌腺（HN）的平均T1和T2值的变化，以评估治疗反应。未受累的正常组织（脑白质外观正常，HN咬肌）评估受试者内重复性。结果：Phantom benchmarking显示了良好的会话间重复性（变异系数平均值|平均值|平均值|平均值|平均值= 155 ms(13.7%)）和坏死设置(ΔT1mean = 214-502 ms （17.6-39.7%)， ΔT2mean = 7-41 ms(8.7-41.4%)， 6个月至3个月的PostTx）。在HN中，两个舌基肿瘤表现为T2增强(PostTx GTV ΔT2mean > 7 ms （12.8%), RD ΔT2mean > 10 ms(18.1%)）。与节点疾病案例解决PostTx(制造中心ΔT1mean = -541(-39.5%),女士ΔT2mean = -24毫秒(-32.7%)、RDΔT1mean = -400(-29.2%),女士ΔT2mean = -25毫秒(-35.3%))。邻近病变的腮腺(PostTx ΔT1mean bbb82 ms （12.4%)， ΔT2mean > 6 ms(13.4%)）和下颌骨腺(PostTx ΔT1mean > 135 ms （14.6%)， ΔT2mean > 17 ms(34.5%)）表现出增强，而远处器官保持稳定。结论：初步结果表明DL-MUPA有望用于治疗反应评估，并突出了功能保留的潜在终点。

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

Journal of Applied Clinical Medical Physics 医学-核医学

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