British Journal of Radiology最新文献

{"title":"Multienergy cardiovascular CT imaging: current state and future.","authors":"Konstantin Klambauer, Costanza Lisi, Lukas Jakob Moser, Victor Mergen, Thomas Flohr, Matthias Eberhard, Hatem Alkadhi","doi":"10.1093/bjr/tqae246","DOIUrl":"10.1093/bjr/tqae246","url":null,"abstract":"<p><p>Multienergy cardiovascular CT imaging can be defined as data acquisition at 2 (dual-energy) or multiple X-ray energies. Multienergy cardiovascular CT imaging provides additional qualitative and quantitative information such as material maps or virtual monoenergetic images, which are supposed to further improve the quality and diagnostic yield of CT. Recently introduced photon-counting detector CT scanners further address some of the challenges and limitations of previous, conventional CT machines, hereby enhancing and extending the applications of CT for cardiovascular imaging. This review summarizes the technical principles of multienergy cardiovascular CT imaging and addresses the optimization of image quality and discusses the various dual-energy-based applications for coronary, valvular, and myocardial imaging. New developments in regard to k-edge imaging and new contrast media for multienergy cardiovascular CT imaging are being also discussed.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"321-329"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric MRI assessment of primary tumours for predicting axillary tumour burden in women with invasive breast cancer.","authors":"Jin Joo Kim, Jin You Kim, Kyung Jin Nam, Kye Young Lee, Ki Seok Choo, Taewoo Kang, Heeseung Park, Seong Hwan Bae","doi":"10.1093/bjr/tqae243","DOIUrl":"10.1093/bjr/tqae243","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between multiparametric MRI features of primary tumours and axillary lymph node tumour burden in women with invasive breast cancer.</p><p><strong>Methods: </strong>In this retrospective study, women diagnosed with invasive breast cancer who underwent 3T multiparametric MRI, including diffusion-weighted imaging (DWI) from 2019 to 2020, were evaluated. Two radiologists reviewed T2-weighted images (T2WI) for peritumoural oedema and intratumoural necrosis and measured apparent diffusion coefficient (ADC) values by manually placing regions of interest within breast tumours. We also analysed quantitative kinetic features of breast cancer using computer-aided diagnosis (CAD) and clinical-pathologic characteristics. Uni- and multivariable logistic regression analyses were conducted to identify predictors of a high axillary nodal burden (≥3 positive nodes).</p><p><strong>Results: </strong>In total, 301 women (mean age, 54.13 years) were evaluated. Forty-three (14.3%) had a high axillary nodal burden by surgical pathology. Multivariate analysis revealed that factors significantly associated with high axillary nodal burden included peritumoural oedema (OR: 7.970; P < .001), lower tumour ADCmax (≤1.098 × 10-3 mm2/s) (OR: 6.978; P < .001), larger tumour size (>2 cm) (OR: 2.986; P = .046), lobular histology (OR: 12.620; P < .001), and the presence of lymphovascular invasion (OR: 3.622; P = .003). CAD-derived kinetic features did not show an association with axillary nodal burden. In subgroup analysis of 238 patients with early clinically node-negative breast cancer, both peritumoural oedema (OR: 7.831; P = .002) and lower tumour ADCmax (≤1.098 × 10-3 mm2/s) (OR: 8.002; P = .002) remained significant predictors.</p><p><strong>Conclusion: </strong>Our results suggest that peritumoural oedema as viewed in T2WI and the ADCmax value of breast cancer in DWI are valuable for predicting axillary nodal burden in women with invasive breast cancer.</p><p><strong>Advances in knowledge: </strong>Multiparametric MRI features of a primary tumour are useful for predicting axillary nodal burden in patients with invasive breast cancer.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"432-440"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial or focal brachytherapy for prostate cancer: a systematic review and meta-analysis.","authors":"Enrique Gutiérrez-Valencia, Inmaculada Navarro-Domenech, Kailee Zhou, Marc Barcelona, Rouhi Fazelzad, Matthew Ramotar, Irving Sanchez, Victor Ruiz, Robert Weersink, Rachel Glicksman, Joelle Helou, Alejandro Berlin, Peter Chung, Ronald Chow, Srinivas Raman","doi":"10.1093/bjr/tqae254","DOIUrl":"10.1093/bjr/tqae254","url":null,"abstract":"<p><strong>Objectives: </strong>Recent advances in image-guided brachytherapy have allowed for treatment volume reduction in the treatment of prostate cancer, with the aim to optimize disease control and reduce toxicities. This systematic review reports on the efficacy and safety of focal brachytherapy for treatment of patients with localized prostate cancer.</p><p><strong>Methods: </strong>Medline, Embase, Web of Science, and Cochrane were searched from inception to July 2023. Studies were included if they reported on focal brachytherapy, and described either dosimetry or clinical outcomes in the monotherapy or salvage setting. Meta-analysis was conducted to estimate biochemical control (BC) at 12-60 months. The review protocol was registered on PROSPERO (CRD42022320921).</p><p><strong>Results: </strong>Twenty-six studies reporting on 1492 patients were included in this review. Fourteen studies reported on monotherapy, 10 on salvage, and two on boost. The majority of studies used MRI and/or biopsy or PET for target identification, and MRI fusion and transrectal ultrasound (TRUS) for image guidance technique. BC for monotherapy was 97% (95% CI: 86%-99%) at 24 months and 82% (95% CI: 65%-92%) at 60 months. BC for salvage was 67% (95% CI: 62%-72%) at 24 months and 35% (95% CI: 17%-58%) at 60 months. Low rates of toxicity were reported across studies.</p><p><strong>Conclusions: </strong>Focal brachytherapy has promising efficacy and safety profiles. Future studies may compare focal brachytherapy to whole-gland treatments, to investigate relative efficacy and safety.</p><p><strong>Advances in knowledge: </strong>In well-selected patients, partial or focal brachytherapy represents an evidence-based option with acceptable BC rates and a favourable toxicity profile.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"354-367"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining normal enthesis stiffness range in a healthy adult population.","authors":"Mohammad Khairi Jahidi Mahazer, Sook Sam Leong, Jeannie Hsiu Ding Wong, Faizatul Izza Rozalli, Fariz Yahya, Ying Chew Tee, Mazuin Mohd Razalli, Anushya Vijayananthan, Hazlyna Baharuddin","doi":"10.1093/bjr/tqae250","DOIUrl":"10.1093/bjr/tqae250","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the correlation between volunteer demographics with enthesis stiffness and intra- and interobserver agreements using shear wave elastography (SWE).</p><p><strong>Methods: </strong>Ninety-eight healthy volunteers were recruited. SWE was performed on quadriceps, suprapatellar, infrapatellar, and Achilles entheses. The stiffness measurements were measured in shear wave velocity (SWV).</p><p><strong>Results: </strong>Mann-Whitney test revealed insignificant difference in SWV among gender. Wilcoxon signed-rank test showed significant difference in SWV between left and right Achilles entheses. Spearman correlation test revealed moderate negative correlation between SWV and age group in quadriceps (ρ, -0.45, P < .01), and weak negative correlation in suprapatellar (ρ, -0.31, P < .01), and left Achilles (ρ, -0.29, P < .01). Multiple linear regression analysis showed subjects' demographic significantly predicted quadriceps, suprapatellar, and left Achilles entheses stiffness with only age statistically significantly to the prediction (P < .05). Kruskal-Wallis showed significant differences in SWV for quadriceps (P = .01), suprapatellar (P = .03), and left Achilles (P = .01) among different age groups. Good interobserver [0.79-0.86 (95% CI, 0.32-0.94)] and interobserver agreement [0.78-0.89 (95% CI, 0.62-0.95)] were found in all the entheses.</p><p><strong>Conclusion: </strong>SWE emerges as a reproducible method for entheses stiffness quantification, with the study highlighting age as a significant factor impacting SWV in quadriceps, suprapatellar, and left Achilles entheses. Among the studied entheses, SWV for Achilles enthesis is the highest in all age groups.</p><p><strong>Advances in knowledge: </strong>The study significantly contributes to the understanding of enthesis stiffness by exploring the influence of gender, BMI, and age.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"469-474"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of dynamic contrast-enhanced breast magnetic resonance imaging and diffusion-weighted imaging findings for sentinel lymph node metastasis in early-stage invasive breast cancer.","authors":"Almila Coskun Bilge, Isil Esen Bostanci","doi":"10.1093/bjr/tqaf005","DOIUrl":"10.1093/bjr/tqaf005","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study aimed to evaluate the predictive value of the preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) findings of mass lesions for predicting sentinel lymph node (SLN) metastasis in early breast cancer.</p><p><strong>Methods: </strong>A total of 310 patients with suspicious mass lesions detected in preoperative MRI who subsequently underwent surgery and SLN biopsy (SLNB) between September 2015 and September 2022 were analysed. The relationship between DCE-MRI and DWI findings and SLNB positivity was analysed.</p><p><strong>Results: </strong>SLNB was positive for SLN metastasis in 108 of 310 lesions. Younger age (P = 0.001) and larger lesion size (P < 0.001) were found to be associated with SLNB positivity. Findings associated with SLN metastasis included peritumoural oedema in 53%, adjacent vessel sign (AVS) in 81%, and increased whole-breast vascularity (WBV) in 58% of patients with positive SLNB (P < 0.001). The SLNB positivity rate was higher in mass lesions with DCE-MRI findings of heterogenous enhancement pattern (P = 0.003), medium or rapid initial phase enhancement (P = 0.001), and washout delayed phase kinetic curve (P = 0.001). It was found that lower tumoural apparent diffusion coefficient (ADC) values (P = 0.003) and higher peritumoural/tumoural ADC ratios (P = 0.018) increased the probability of encountering SLN metastasis.</p><p><strong>Conclusions: </strong>Patient age, presence of peritumoural oedema, presence of AVS, increased WBV, and initial phase kinetic curve of the lesions on MRI were found to be associated with SLN metastasis.</p><p><strong>Advances in knowledge: </strong>We found that younger age and MR findings obtained from the perilesional area of breast cancer may be helpful in the preoperative prediction of SLN metastasis.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"475-482"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of kilovoltage radiotherapy treatment in the United Kingdom: quality control, radiation dosimetry, treatment equipment, and workload.","authors":"Antony L Palmer, Jason Brimelow, Patrick Downes, Mayur Munshi, David Nash, Bhupinder Rai, Andrew R White","doi":"10.1093/bjr/tqaf001","DOIUrl":"10.1093/bjr/tqaf001","url":null,"abstract":"<p><strong>Objectives: </strong>To survey kilovoltage (kV) radiotherapy in the United Kingdom, updating a 2016 study, focussing on radiotherapy physics, including equipment quality control (QC) and radiation dosimetry, with information on installed equipment and clinical activity.</p><p><strong>Methods: </strong>All UK radiotherapy physics departments (n = 68) were invited to complete a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical activity, QC testing, and radiation dosimetry processes were undertaken.</p><p><strong>Results: </strong>91% of centres (n = 62) responded to the survey. kV radiotherapy was available in 70% of UK radiotherapy departments, with a wide variation in workload; 7-436 patients/centre annually. There has been an increase in centres using treatment calculation software rather than manual methods, up from 36% in 2016 to 50% currently. Only 50% of centres use an independent calculation check method. There was an increase in the use of the addendum to the UK dosimetry code of practice, enabling medium energy calibration in-air rather than at depth in phantom, citing \"clinical relevance.\" Appropriate levels of QC testing were being conducted at UK centres, with Institute of Physics and Engineering in Medicine (IPEM) Report 81 cited as a primary source of guidance. Good consensus for the frequency and tolerance values used for QC was seen across UK centres.</p><p><strong>Conclusions: </strong>A comprehensive review of consensus practice for QC and dosimetry in kV radiotherapy across the United Kingdom is presented, with supporting information on equipment installation and clinical use.</p><p><strong>Advances in knowledge: </strong>Updated data are presented on kV radiotherapy treatment in the United Kingdom, with focus on physics aspects of QC and dosimetry.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"392-403"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A generalized health index: automated thoracic CT-derived biomarkers predict life expectancy.","authors":"Cameron Beeche, Tong Yu, Jing Wang, David Wilson, Pengyu Chen, Emrah Duman, Jiantao Pu","doi":"10.1093/bjr/tqae234","DOIUrl":"10.1093/bjr/tqae234","url":null,"abstract":"<p><strong>Objective: </strong>To identify image biomarkers associated with overall life expectancy from low-dose CT and integrate them as an index for assessing an individual's health.</p><p><strong>Methods: </strong>Two categories of CT image features, body composition tissues and cardiopulmonary vasculature characteristics, were quantified from LDCT scans in the Pittsburgh Lung Screening Study cohort (n = 3635). Cox proportional-hazards models identified significant image features which were integrated with subject demographics to predict the subject's overall hazard. Subjects were stratified using composite model predictions and feature-specific risk stratification thresholds. The model's performance was validated extensively, including 5-fold cross-validation on PLuSS baseline, PLuSS follow-up examinations, and the National Lung Screening Trial (NLST).</p><p><strong>Results: </strong>The composite model had significantly improved prognostic ability compared to the baseline model (P < .01) with AUCs of 0.774 (95% CI: 0.757-0.792) on PLuSS, 0.723 (95% CI: 0.703-0.744) on PLuSS follow-up, and 0.681 (95% CI: 0.651-0.710) on the NLST cohort. The identified high-risk stratum were several times more likely to die, with mortality rates of 79.34% on PLuSS, 76.47% on PLuSS follow-up, and 46.74% on NLST. Two cardiopulmonary structures (intrapulmonary artery-vein ratio, intrapulmonary vein density) and two body composition tissues (SM density, bone density) identified high-risk patients.</p><p><strong>Conclusions: </strong>Body composition and pulmonary vasculatures are predictive of an individual's health risk; their integrations with subject demographics facilitate the assessment of an individual's overall health status or susceptibility to disease.</p><p><strong>Advances in knowledge: </strong>CT-computed body composition and vasculature biomarkers provide improved prognostic value. The integration of CT biomarkers and patient demographic information improves subject risk stratification.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"412-421"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving radiology reporting locally and globally: who, how, and why?","authors":"Kirsten L Gormly","doi":"10.1093/bjr/tqae253","DOIUrl":"10.1093/bjr/tqae253","url":null,"abstract":"<p><p>The radiology report is the communication from radiologist to referrer, used to inform prognosis and guide patient management. The report is the final step in a process which is influenced by the information on the referral, image quality, the reporting environment, and appropriate detection and interpretation of findings by the radiologist. It should present accurate, complete information in a way that can be easily understood. Even small improvements in any of these areas can have a significant impact on the average quality of radiology reports, with potential impact on vast numbers of patients across the globe. How do we train our future referrers to understand the complexities of imaging and write better referrals? How do we improve image quality as close to source as possible by engaging with equipment vendors? How can we make it easier for all radiologists to have access to the latest guidelines and use reporting templates where appropriate? Every radiologist has a role to play, with possible actions ranging from individual choice to departmental policies and global collaboration. The diseases we diagnose are the same, the equipment similar and knowledge freely available. All our patients deserve the best report we can provide.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"330-335"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-based liver peritumoural radiomics features predict hepatic metastases sources as gastrointestinal or non-gastrointestinal.","authors":"Chengshi Hou, Fang Wang, Martin Prince, Xin Yang, Wenjian Wang, Jing Ye, Lei Chen, Xianfu Luo","doi":"10.1093/bjr/tqae248","DOIUrl":"10.1093/bjr/tqae248","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the feasibility of radiomics models for predicting the source of hepatic metastases from gastrointestinal (GI) vs non-gastrointestinal (non-GI) primary tumours on contrast-enhanced CT (CECT).</p><p><strong>Methods: </strong>Three hundred and forty-seven patients with liver metastases (180 from GI and 167 from non-GI) and abdominal CECT including arterial, portal venous, and delayed phases were divided into training (221) and validation (96) sets at a ratio of 7:3 and an independent testing set (30). Radiomics features were extracted from volumes of interest (VOIs) including tumoural (Vtc) and peritumoural (Vpt) regions on CECT. Optimal radiomics features were used in logistic regression models using receiver operating curve (ROC) analysis to evaluate the diagnostic efficiency.</p><p><strong>Results: </strong>The best single-phase model was a venous phase peritumoural VOI with 11 features. Area under the curve (AUC), sensitivity, and specificity were 0.817, 0.740, and 0.761, respectively in the validation set. While the best arterial phase tumoural VOI gave an AUC of 0.677 in the validation set. For the combined models, peritumoural VOI in arterial and venous phases (15 features) achieved the best prediction performance with an AUC of 0.926 in the validation set and 0.884 in the testing set.</p><p><strong>Conclusion: </strong>Liver peritumoural radiomics features extracted from CECT were able to identify the source of hepatic metastases as GI vs non-GI.</p><p><strong>Advances in knowledge: </strong>Peritumoural radiomics features showed a correlation with source of liver metastases. The radiomics features from liver peritumoural arterial and venous phases CT were promising in differentiating the source of hepatic metastases from GI vs non-GI primary tumours.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"458-468"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated contouring and radiotherapy treatment planning of spine metastases using atlas-based auto-segmentation and knowledge-based planning approaches.","authors":"Emma-Louise Jones, Porsher Oppong, Caroline Sisodia, Carolina Napoleone-Filho, Victoria Harris, Christopher Golby, David Eaton, Antony Greener","doi":"10.1093/bjr/tqaf041","DOIUrl":"https://doi.org/10.1093/bjr/tqaf041","url":null,"abstract":"<p><strong>Objectives: </strong>Uncomplicated spine metastases are routinely treated with conventional external beam radiotherapy (cEBRT). In cEBRT, there is no delineation of target volumes or organs at risk (OAR), or attempt to optimise dose distribution to deliver conformal, homogeneous dose distributions with sparing of OAR. Atlas-based auto-segmentation (ABAS) for target volume and OAR delineation, followed by knowledge-based planning (KBP) could facilitate conformal planning of spine metastases.</p><p><strong>Methods: </strong>ABAS using SmartSegmentation for delineation of thoracic and lumbar vertebrae, and OAR in their vicinity, provided target volumes and OAR for conformal treatment planning. 30 volumetric-modulated arc therapy (VMAT) treatment plans were produced using RapidPlan KBP. Plans produced using this automated approach were compared to the equivalent cEBRT treatment plans.</p><p><strong>Results: </strong>Target volume coverage for RapidPlan VMAT generated plans was superior to cEBRT. PTV Dmean = 7.86 ± 0.16 Gy, Dmin = 3.46 ± 1.79 Gy, Dmax = 8.56 ± 0.05 Gy for RapidPlan VMAT compared to Dmean = 7.78 ± 0.24 Gy, Dmin = 1.83 ± 1.08 Gy, Dmax = 10.46 ± 0.41 Gy for cEBRT. With homogeneity index and conformity index 0.236 ± 0.215 and 1.201 ± 0.121 respectively for RapidPlan VMAT compared to 0.508 ± 0.137 and 1.789 ± 0.437 for cEBRT. Dose to dose-limiting OAR spinal cord and cauda equina was reduced for RapidPlan VMAT, with Dmax of 7.91 ± 0.16 Gy and 7.94 ± 0.13 Gy respectively compared to 8.67 ± 0.13 Gy and 8.90 ± 0.16 Gy for cEBRT. KBP was superior to cEBRT in terms of target coverage, homogeneity and conformity and was achievable in a clinically acceptable time, with improved sparing of the spinal cord and cauda equina.</p><p><strong>Conclusions: </strong>Implementation of automated treatment planning for uncomplicated spine metastases is feasible in the clinical environment with superior plan quality compared to cEBRT.</p><p><strong>Advances in knowledge: </strong>Automated contouring and treatment planning are feasible in the clinical environment using this approach and would allow patients conformal as opposed to conventional external beam radiotherapy for treatment of spine metastases.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}