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Clinical workflow for MR-only simulation and planning in prostate.
Neelam Tyagi1, Sandra Fontenla2, Michael Zelefsky3
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. tyagin@mskcc.org.
Radiation Oncology (London, England)
|July 19, 2017
Summary
This study demonstrates that Magnetic Resonance (MR)-only simulation is feasible for prostate cancer radiotherapy, offering time savings and accurate treatment planning. The workflow achieved comparable or superior results to traditional CT-MR methods.
Area of Science:
- Radiotherapy Physics and Technology
- Medical Imaging and Radiation Oncology
Background:
- Traditional radiotherapy simulation often combines Computed Tomography (CT) and Magnetic Resonance (MR) imaging.
- MR-only simulation offers potential benefits in workflow efficiency and radiation dose reduction.
Purpose of the Study:
- To detail the implementation and clinical experience of an MR-only workflow for prostate cancer patient simulation and planning.
- To evaluate the feasibility and accuracy of MR-only simulation in a clinical setting.
Main Methods:
- MR-only simulation was performed on 48 prostate cancer patients using T2w, synthetic-CT (Syn-CT) generation (MRCAT), and fiducial identification sequences.
- An automated MIM™ workflow facilitated contouring on MR images.
- Treatment setup localization utilized MRCAT-generated digitally reconstructed radiographs (DRRs) matched with KV radiographs.
Main Results:
- Forty-two patients (87.5%) successfully completed MR-only simulation, meeting institutional dosimetric objectives.
- MR-only simulation resulted in an approximate 15-minute time saving compared to CT+MR workflows.
- Contouring accuracy and speed improved with the automated workflow; treatment setup localization was successful in all cases.
Conclusions:
- MR-only simulation and planning are clinically feasible, providing equivalent or superior accuracy in target delineation, planning, and treatment setup localization.
- Future research will focus on robust 3D isotropic acquisitions for enhanced contouring.
