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MRI-based treatment plan simulation and adaptation for ion radiotherapy using a classification-based approach.

Christopher M Rank1, Christoph Tremmel, Nora Hünemohr

  • 1German Cancer Research Center (DKFZ), Division of Medical Physics in Radiation Oncology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. c.rank@dkfz.de

Radiation Oncology (London, England)
|March 19, 2013
PubMed
Summary

This study shows MRI can create pseudo CT images for ion radiotherapy planning. While errors exist, they are comparable to target shifts, making it suitable for adaptive radiotherapy.

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Medical Imaging

Background:

  • Ion radiotherapy offers conformal tumor irradiation, necessitating advanced treatment planning and simulation.
  • Magnetic Resonance Imaging (MRI) shows potential for enhancing ion radiotherapy treatment simulations.

Purpose of the Study:

  • To investigate MRI's utility for ion radiotherapy treatment plan simulation and adaptation.
  • To evaluate a classification-based approach for generating pseudo CT data from MRI.

Main Methods:

  • Voxelwise tissue classification derived pseudo CT numbers from multi-contrast MR images.
  • MR sequences and parameters were optimized using phantom cross-validation studies.
  • Ion radiotherapy plans were optimized using pseudo CT and reference CT, with subsequent recalculations and adaptation simulations.

Main Results:

  • Pseudo CT generation resulted in mean absolute errors of 81-95 HU, with deviations at tissue-air and bone interfaces.
  • Ion radiotherapy simulations using pseudo CT showed minimal underdosage (1.4-3.1%) in distal target regions compared to reference CT.
  • An adapted plan optimized on pseudo CT achieved dose coverage comparable to a non-adapted plan on reference CT.

Conclusions:

  • MRI-based pseudo CT generation via statistical classification is feasible, despite lacking a direct physical correlation.
  • Significant errors occurred with compact bone due to imperfect MRI tissue differentiation.
  • Deviations are comparable to target shift uncertainties, highlighting potential for adaptive ion radiotherapy applications.