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Finite Element Method-Based Hybrid MRI/CBCT Generation to Improve Liver Stereotactic Body Radiation Therapy Targets

Zeyu Zhang1, Mark Chen2, Ke Lu3

  • 1Medical Physics Graduate Program, Duke University, Durham, NC 27705 USA.

IEEE Transactions on Radiation and Plasma Medical Sciences
|September 18, 2025
PubMed
Summary

This study introduces a hybrid MRI/CBCT method to improve liver tumor localization accuracy in radiation therapy. By combining MRI and CBCT, this technique enhances soft-tissue contrast, potentially reducing errors and improving treatment outcomes.

Keywords:
Finite element analysis (FEA)MR-cone beam computed tomography (CBCT)image registration

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Area of Science:

  • Medical Imaging
  • Radiation Oncology
  • Computational Anatomy

Background:

  • Cone-beam CT (CBCT) offers limited soft tissue contrast for liver tumor localization.
  • Current indirect localization methods lack precision, especially for tumors away from the liver boundary.
  • Onboard MRI provides better contrast but is cost-prohibitive for widespread use.

Purpose of the Study:

  • To develop and evaluate a hybrid MRI/CBCT (hMRI-CBCT) method for enhanced liver tumor localization.
  • To improve the accuracy of tumor targeting in liver stereotactic body radiation therapy (SBRT).
  • To overcome the limitations of CBCT's soft tissue contrast and MRI's cost.

Main Methods:

  • Integration of pretreatment MRI with onboard CBCT using a finite element method (FEM) for deformable mapping.
  • Deformation of prior liver MR images onto CBCT geometry to generate a virtual MRI.
  • Evaluation of the hMRI-CBCT approach in a pilot study of 48 patients.

Main Results:

  • The hMRI-CBCT approach provided excellent soft-tissue contrast and clear tumor visualization.
  • Registration accuracy of hMRI-CBCT to planning CT significantly outperformed onboard CBCT to planning CT registration.
  • An average reduction in localization error of 1.53 ± 2.16 mm was observed, particularly for tumors not near the liver boundary.

Conclusions:

  • Hybrid MRI/CBCT effectively reduces localization errors in liver SBRT.
  • This method holds potential for improving tumor control and reducing treatment toxicities.
  • The hMRI-CBCT technique may enable further margin reduction and dose escalation in liver SBRT.