Radiologia Medica最新文献_第3页

Ablation of symptomatic uterine fibroids with the Mirabilis system for rapid noninvasive ultrasound-guided high-intensity focused ultrasound (HIFU): a prospective observational clinical study. Mirabilis系统快速无创超声引导下高强度聚焦超声（HIFU）消融症状性子宫肌瘤的前瞻性观察临床研究

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-05-01 Epub Date: 2025-03-10 DOI: 10.1007/s11547-025-01972-6

Tolga Tonguc, Oleksandr Savchenko, Olga Ramig, Judith M Stader, Franziska Kießling, Jim Küppers, Eva K Egger, Marcus Thudium, Patrick Martin, Wayne Poll, Hans H Schild, Rupert Conrad, Markus Essler, Alexander Mustea, Holger M Strunk, Milka Marinova

{"title":"Ablation of symptomatic uterine fibroids with the Mirabilis system for rapid noninvasive ultrasound-guided high-intensity focused ultrasound (HIFU): a prospective observational clinical study.","authors":"Tolga Tonguc, Oleksandr Savchenko, Olga Ramig, Judith M Stader, Franziska Kießling, Jim Küppers, Eva K Egger, Marcus Thudium, Patrick Martin, Wayne Poll, Hans H Schild, Rupert Conrad, Markus Essler, Alexander Mustea, Holger M Strunk, Milka Marinova","doi":"10.1007/s11547-025-01972-6","DOIUrl":"10.1007/s11547-025-01972-6","url":null,"abstract":"Objectives: Uterine fibroids often lead to symptoms that negatively impact health-related quality of life (HRQOL). High-intensity focused ultrasound (HIFU) has emerged as a promising noninvasive treatment for reducing fibroid size and symptoms. The Mirabilis system for ultrasound (US)-guided HIFU introduces a novel technique known as 'shell ablation'. This study evaluates the feasibility and efficacy of Mirabilis in a clinical setting, focusing on clinical outcomes.Materials and methods: Sixteen patients with 23 uterine fibroids were treated with the Mirabilis system. Follow-up assessments included US and MRI at baseline, 6 weeks, 3, 6 and 9 months, and 1 year after HIFU. Changes in symptoms and QOL were evaluated using the Uterine Fibroid Symptom and HRQOL Questionnaire.Results: A significant reduction in fibroid volume was observed after HIFU (baseline 182.1 ± 49.3 ml; 1 year: 76.0 ± 37.9 ml, p < 0.001). The symptom severity score significantly declined (baseline 57.2 ± 3.8; 1 year: 30.2 ± 4.9, p < 0.001), correlating with a significant improvement in HRQOL (baseline 47.0 ± 3.9, 1 year: 71.8 ± 5.3, p < 0.001).Conclusion: HIFU with the portable Mirabilis system is a feasible and safe noninvasive treatment for symptomatic uterine fibroids in an outpatient setting. This approach allows efficient and rapid ablation even for large fibroids, significantly reducing fibroid volume and symptoms.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"629-637"},"PeriodicalIF":9.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transvenous pulmonary chemoembolization and microwave ablation for lung metastases from breast cancer: a propensity score matching analysis. 经静脉肺化疗栓塞和微波消融治疗乳腺癌肺转移：倾向得分匹配分析。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-05-01 Epub Date: 2025-03-18 DOI: 10.1007/s11547-025-01966-4

Hamzah Adwan, Lars Hammann, John Bielfeldt, Sven Becker, Thomas J Vogl

{"title":"Transvenous pulmonary chemoembolization and microwave ablation for lung metastases from breast cancer: a propensity score matching analysis.","authors":"Hamzah Adwan, Lars Hammann, John Bielfeldt, Sven Becker, Thomas J Vogl","doi":"10.1007/s11547-025-01966-4","DOIUrl":"10.1007/s11547-025-01966-4","url":null,"abstract":"Purpose: To compare the outcomes of patients with pulmonary metastases from breast cancer, who were treated with transvenous pulmonary chemoembolization (TPCE) and consecutive microwave ablation (MWA) with patients treated by TPCE alone.Material and methods: This retrospective single-center study included patients with unresectable and/or non-responsive to systemic chemotherapy pulmonary metastases originating from breast cancer, treated by TPCE followed by MWA, in case of adequate response to TPCE, or by TPCE alone. The groups of patients were balanced using propensity score matching (PSM).Results: A total of 97 patients met the inclusion criteria for this study. After PSM, 23 patients were included in the combination therapy group (Group 1) and 42 patients were included in the monotherapy group (Group 2). The median overall survival (OS) time was 33.6 months for Group 1 with a 2-year OS rate of 62%, and 20.2 months for Group 2 with a 2-year OS rate of 43%. There was no significant difference between the two groups regarding OS (p value: 0.429). The rate of progressive/recurrent disease was 17.4% (4/23) in Group 1 and 23.8% (10/42) in Group 2 (p value: 0.754). The number of metastases was the only significant factor for OS in all patients after PSM (p value: 0.032, HR: 1.016, 95% CI 1.001-1.031).Conclusion: TPCE is an effective potential treatment for lung metastases of breast cancer, which can be performed alone or combined with MWA. Patients who responded to TPCE and received subsequent MWA demonstrated non-significant better OS and local tumor control.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"706-713"},"PeriodicalIF":9.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can MRI predict return to sport after anterior cruciate ligament reconstruction? A systematic review of the literature. MRI能否预测前交叉韧带重建后重返运动？对文献的系统回顾。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-05-01 Epub Date: 2025-03-10 DOI: 10.1007/s11547-025-01973-5

Riccardo D'Ambrosi, Luca Maria Sconfienza, Domenico Albano, Amit Meena, Elisabeth Abermann, Christian Fink

{"title":"Can MRI predict return to sport after anterior cruciate ligament reconstruction? A systematic review of the literature.","authors":"Riccardo D'Ambrosi, Luca Maria Sconfienza, Domenico Albano, Amit Meena, Elisabeth Abermann, Christian Fink","doi":"10.1007/s11547-025-01973-5","DOIUrl":"10.1007/s11547-025-01973-5","url":null,"abstract":"Purpose: To analyze whether magnetic resonance imaging (MRI) can predict return to sport after anterior cruciate ligament (ACL) reconstruction and whether a correlation exists between return to sports, level of activity and MRI signals.Methods: The search terms selected for inclusion in the title, abstract, and keyword fields were as follows: 'anterior cruciate ligament' OR 'ACL' AND 'graft maturation' OR 'MRI' AND 'return to sport' OR 'sports activity.' For each study, patient data and the MRI protocol used to assess graft maturation were extracted. An analysis of the correlations between MRI and ACL reconstruction was performed.Results: A total of 394 patients were included from 7 studies. The mean radiological follow-up was 19.06 ± 11.02 months. Three studies reported no correlations between graft bending angle, signal/noise ratio, signal intensity or Howell score and return to sport. One study revealed that T2* was correlated with return to sport. A further investigation demonstrated that those who were able to regain their preinjury athletic performance exhibited considerably lower ACL/PCL ratio and ACL/muscle ratio of the ACL mid-substance compared to those who were unable to attain the same level of athletic performance. Only one study reported correlations between 12-month SNRs and 60-month Cincinnati, Lysholm and Tegner activity scales, whereas Biercevicz revealed that the combination of volume and the SI predicted the KOOS score at the 5-year follow-up.Conclusions: There are no reliable radiological parameters available that correlate with return to sport after anterior cruciate ligament reconstruction, but MRI can potentially play a key role in closing this gap.Level of evidence: Systematic review of level IV.Study registration: PROSPERO-CRD42024574365.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"638-649"},"PeriodicalIF":9.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In reply to the letter to editor by Paz-Manrique et al. regarding "What the urologist needs to know before radical prostatectomy: MRI effective support to pre-surgery planning". 回复Paz-Manrique等人关于“泌尿科医生在根治性前列腺切除术前需要知道的事情：MRI对术前计划的有效支持”致编辑的信。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-30 DOI: 10.1007/s11547-025-02011-0

Ludovica Laschena, Emanuele Messina, Rocco Simone Flammia, Antonella Borrelli, Simone Novelli, Daniela Messineo, Costantino Leonardo, Alessandro Sciarra, Valeria Panebianco

引用次数: 0

Letter to the Editor regarding "What the urologist needs to know before radical prostatectomy: MRI effective support to pre‑surgery planning": Open Radical Prostatectomy Remains Relevant. 致编辑关于“泌尿科医生在根治性前列腺切除术前需要知道什么：MRI对术前计划的有效支持”的信：开放性根治性前列腺切除术仍然相关。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-30 DOI: 10.1007/s11547-025-02010-1

Nicanor Rodriguez-Gutarra, Mauricio Vassallo, Roberto Paz-Manrique

引用次数: 0

Myocardial extracellular volume fraction with spectral detector computed tomography for risk stratification in non-ischemic heart failure. 心肌细胞外体积分数与谱检测器计算机断层扫描在非缺血性心力衰竭的危险分层。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-30 DOI: 10.1007/s11547-025-02002-1

Jie Deng, Yu Wang, Tianfu Qi, Zhiming Li, Hongen Zheng, Yan Wu, Lin Lu, Deyan Li, Dan Han, Wei Chen

{"title":"Myocardial extracellular volume fraction with spectral detector computed tomography for risk stratification in non-ischemic heart failure.","authors":"Jie Deng, Yu Wang, Tianfu Qi, Zhiming Li, Hongen Zheng, Yan Wu, Lin Lu, Deyan Li, Dan Han, Wei Chen","doi":"10.1007/s11547-025-02002-1","DOIUrl":"https://doi.org/10.1007/s11547-025-02002-1","url":null,"abstract":"Purpose: To validate the feasibility of using late iodine enhancement (LIE)-derived ECV on iodine density images using spectral detector computed tomography (SDCT; CT-ECV) and to assess the potential of CT-ECV for risk stratification among patients with non-ischemic heart failure (NIHF).Materials and methods: Forty-five subjects who underwent cardiac SDCT and CMR were included in the validation group to calculate and compare CT-ECV with CMR-ECV to validate CT-ECV feasibility. Another 117 subjects (82 patients with NIHF, 35 controls) who underwent SDCT were included in the experimental group to explore the potential of CT-ECV for risk stratification. ECV was measured via iodine density images and CMR T1 mapping in accordance with American Heart Association 16-segment models.Results: In the validation group, there was no significant difference between CT-ECV and CMR-ECV (P = 0.293), with an insignificant bias. In the experimental group, CT-ECV in patients with NIHF was significantly higher than in controls (P < 0.05). In 82 patients with NIHF, CT-ECV in HFrEF ( HF with reduced ejection fraction: LVEF ≤ 40%) patients was statistically higher than that of HFmEF (HF with mildly reduced ejection fraction: LVEF 41-49%) and HFpEF (HF with preserved ejection fraction: LVEF ≥ 50%) patients (P < 0.05) and a significant difference among patients with NIHF with varied New York Heart Association classes (all P < 0.05); In addition, Kaplan-Meier survival curves and Log-rank test demonstrated that NIHF patients with CT-ECV ≥ 31.29% had higher probability of MACE than NIHF patients with CT-ECV < 31.29% (P < 0.001).Conclusion: LIE-derived CT-ECV on iodine density images using SDCT is a promising practical alternative to CMR-ECV, with the potential to assist with risk stratification among patients with NIHF.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advanced radiomic prediction of osteoporosis in primary hyperparathyroidism: a machine learning-based analysis of CT images. 原发性甲状旁腺功能亢进骨质疏松症的先进放射学预测：基于机器学习的CT图像分析。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-24 DOI: 10.1007/s11547-025-02004-z

Antonio Adarve-Castro, Virginia Soria-Utrilla, José Miguel Castro-García, María Dolores Domínguez-Pinos, Francisco Sendra-Portero, Miguel J Ruiz-Gómez, José Algarra-García

{"title":"Advanced radiomic prediction of osteoporosis in primary hyperparathyroidism: a machine learning-based analysis of CT images.","authors":"Antonio Adarve-Castro, Virginia Soria-Utrilla, José Miguel Castro-García, María Dolores Domínguez-Pinos, Francisco Sendra-Portero, Miguel J Ruiz-Gómez, José Algarra-García","doi":"10.1007/s11547-025-02004-z","DOIUrl":"https://doi.org/10.1007/s11547-025-02004-z","url":null,"abstract":"This study aims to assess the proficiency of supervised machine learning techniques in discriminating between normal and abnormal bone mineral density (BMD) by leveraging clinical features and texture analysis of spinal bone tissue in patients diagnosed with primary hyperparathyroidism (PHP). From a total of 219 patients diagnosed with PHP, the 58 who had undergone both DXA and abdominal CT scan were included in this study. BMD was assessed by quantifying the Hounsfield units (HU) and performing texture analysis on every CT scan. The first lumbar vertebral body texture features were extracted by using LifeX 7.3.0 software. Initial classification into normal or abnormal BMD was performed with different machine learning techniques by training a model with the variables obtained from the texture analysis. Differentiating osteopenia from osteoporosis was evaluated by creating two models, one including the variables obtained from the texture analysis and HU and another one which only included the HU. Their performance was evaluated in the validation and test groups by calculating the accuracy, precision, recall, F1 score, and AUC. Bayes demonstrated higher performance for discerning individuals with normal and abnormal BMD, with an AUC of 0.916. The results from the second analysis showed a better performance for the model including the variables obtained from the texture analysis compared to the model that was solely trained with the HU (AUC in the training group of 0.77 vs. 0.65 in the test groups, respectively). In conclusion, analysis of BMD obtained from abdominal CT scans including texture analysis provide a better classification of normal density, osteopenia and osteoporosis in patients with PHP.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simple cystic lesions of the pancreas: image quality and diagnostic accuracy of photon-counting detector computed tomography. 胰腺单纯性囊性病变：光子计数检测器计算机断层扫描的图像质量和诊断准确性。

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-21 DOI: 10.1007/s11547-025-02015-w

Stephan Rau, Thomas Stein, Alexander Rau, Caroline Wilpert, Fabian Pallasch, Balazs Bogner, Sebastian Faby, Fabian Bamberg, Jakob Weiss

{"title":"Simple cystic lesions of the pancreas: image quality and diagnostic accuracy of photon-counting detector computed tomography.","authors":"Stephan Rau, Thomas Stein, Alexander Rau, Caroline Wilpert, Fabian Pallasch, Balazs Bogner, Sebastian Faby, Fabian Bamberg, Jakob Weiss","doi":"10.1007/s11547-025-02015-w","DOIUrl":"https://doi.org/10.1007/s11547-025-02015-w","url":null,"abstract":"Purpose: To evaluate image quality and diagnostic accuracy of photon-counting detector (PCD) CT for the detection of pancreatic cystic lesions (PCLs) compared to energy-integrating detector (EID) CT with MRI serving as reference standard.Material and methods: We included consecutive patients who underwent contrast-enhanced PCD-CT of the abdomen and for whom an additional abdominal EID-CT was available. Multiparametric MRI served as the reference standard. CT images were assessed for the presence of PCLs by three radiologists independently in a blinded reading. Image quality, lesion conspicuity, and diagnostic confidence were rated on a 5-point Likert scale (5 = excellent). The coefficient of variation (CV) and the density difference between PCLs and visually normal pancreatic parenchyma were calculated as quantitative imaging measures. Radiation dose was assessed using CTDIvol [mGy].Results: Among 106 included patients (age 62.7 ± 12.6 years; 45 [42.5%] male), 46 had MRI-confirmed cystic lesions (mean size 8.7 ± 7.4 mm; range 2-45 mm). Diagnostic accuracy for PCLs was significantly higher for PCD-CT vs. EID-CT (area under the curve: 0.81 vs. 0.74; p = 0.002; sensitivity: 76.8% vs. 59.4%). Image quality, lesion conspicuity, and diagnostic confidence were rated superior for PCD-CT vs. EID-CT (all p < 0.001). Quantitative analyses revealed a significantly lower CV (0.19 vs. 0.24; p = 0.002) and a higher density difference (94.1 HU vs. 76.6 HU p < 0.001) between PCLs and visually normal pancreatic parenchyma at lower radiation doses (7.13 vs. 8.68 mGy; p < 0.001) for PCD-CT vs. EID-CT.Conclusion: PCD-CT provided significantly higher diagnostic accuracy and superior image quality for the detection of PCLs compared to conventional EID-CT at lower radiation dose.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The diagnostic role of 2-[¹⁸F]FDG PET/CT in critically ill patients with suspected infection of unknown origin: a real-world experience. 2-[18F]FDG PET/CT在疑似不明原因感染的危重患者中的诊断作用：现实世界的经验

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-21 DOI: 10.1007/s11547-025-02005-y

Domenico Albano, Carlo Rodella, Anna Calabrò, Andor W J M Glaudemans, Giorgio Treglia, Francesco Bertagna

{"title":"The diagnostic role of 2-[18F]FDG PET/CT in critically ill patients with suspected infection of unknown origin: a real-world experience.","authors":"Domenico Albano, Carlo Rodella, Anna Calabrò, Andor W J M Glaudemans, Giorgio Treglia, Francesco Bertagna","doi":"10.1007/s11547-025-02005-y","DOIUrl":"https://doi.org/10.1007/s11547-025-02005-y","url":null,"abstract":"Purpose: 2-Deoxy-2-[18F]-fluoro-D-glucose (2-[18F]FDG) positron emission tomography/computed tomography (PET/CT) is a hybrid imaging tool with an emerging role in the study of several infectious and inflammatory diseases. Its role in critically ill patients admitted to the intensive care unit (ICU) is only marginally investigated. This study aimed to investigate the diagnostic performance and the clinical impact of 2-[18F]FDG PET/CT in the management of critically ill patients with suspected infections of unknown origin.Methods: We retrospectively included 47 ICU patients (mean age 63.6 years, 33 males) who underwent a 2-[18F]FDG PET/CT to look for infection foci. We calculated the diagnostic performance of PET/CT expressed as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. As reference standard, final diagnosis based on microbiological/pathologic data or on clinical follow-up was taken. Moreover, we investigated the impact of PET/CT on clinical management and the association of PET/CT with the main clinical, epidemiological and biochemical parameters.Results: The overall 2-[18F]FDG PET/CT sensitivity in detecting infectious foci was 80% (95%CI 64-91%), specificity 75% (95%CI 35-97%), PPV 94% (95%CI 83-93%), NPV 43% (95%CI 26-61%) and accuracy 79% (95%CI 65-90%). The absence of kidney failure, increase leukocyte count and low glucose level at the time of PET were significantly associated with true positive PET/CT. No adverse events during the transport and PET/CT procedure were registered.Conclusion: PET/CT demonstrated to be an accurate toll for the study of critically ill ICU patients with suspected infections. Kidney failure, leukocyte count and blood glucose were associated with true positive PET/CT.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First clinical application of Comprehensive Motion Management with 1.5T MR-linac on prostate cancer patients treated with radiotherapy: technical aspects and suggested workflow recommendations. 1.5T MR-linac综合运动管理在前列腺癌放疗患者中的首次临床应用：技术方面和建议的工作流程建议

IF 9.7 1区医学

Radiologia Medica Pub Date : 2025-04-21 DOI: 10.1007/s11547-025-02014-x

Luca Nicosia, Michele Rigo, Roberto Giuseppe Pellegrini, Andrea Gaetano Allegra, Chiara De-Colle, Niccolò Giaj-Levra, Edoardo Pastorello, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi

{"title":"First clinical application of Comprehensive Motion Management with 1.5T MR-linac on prostate cancer patients treated with radiotherapy: technical aspects and suggested workflow recommendations.","authors":"Luca Nicosia, Michele Rigo, Roberto Giuseppe Pellegrini, Andrea Gaetano Allegra, Chiara De-Colle, Niccolò Giaj-Levra, Edoardo Pastorello, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi","doi":"10.1007/s11547-025-02014-x","DOIUrl":"https://doi.org/10.1007/s11547-025-02014-x","url":null,"abstract":"Purpose: MR-guided radiotherapy (MRgRT) on the MR-linac (MRL) with daily online plan adaptation enables better control of inter-fraction variability. Recently, Comprehensive Motion Management (CMM) was introduced for the 1.5T MRL. CMM halts dose delivery when the target moves outside its defined position and allows for target drift corrections, compensating for intra-fraction variability. This study aims to report the first clinical experience with prostate MRgRT using CMM, focusing on intra-fraction motion management and treatment delivery time.Material and methods: Sixty patients with low- to intermediate-risk prostate cancer were treated with the 1.5T MRL using CMM. PTV margins were 5 mm in all directions, with a 3-mm margin posteriorly. Fifty patients received ultra-hypofractionated radiotherapy (SBRT), and 10 received hypofractionated radiotherapy (hypoRT). The CMM threshold was set to 100% of the GTV volume.Results: A total of 450 treatment fractions were administered. The median beam-on time was 10.3 min, with a median duty cycle of 98.9% (95% CI 98.6-99.2%). Beam hold occurred in 158 fractions (35%), with an average of 24.5 instances per fraction (95% CI 16-32). Thirty-two baseline shift replans were performed. Both acute and late toxicities were low, with no Grade 3 or higher toxicities.Conclusions: CMM has been successfully implemented in MRgRT. In-treatment corrections and baseline shift replanning did not significantly impact treatment time, enhancing treatment quality without compromising patient compliance or treatment feasibility. The low incidence of beam-hold events suggests that CMM could potentially allow for a safe reduction in PTV margins.","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0