Optimising patient positioning in magnetic resonance imaging for image Co-registration in radiosurgery planning

Integrating magnetic resonance imaging (MRI) and stereotactic radiosurgery (SRS) has revolutionised cancer treatment, enhancing precision and improving patient outcomes. MRI/CT image fusion improves the visualisation of targets and surrounding tissues, supporting accurate radiotherapy planning. This study evaluates the impact of multidisciplinary cooperation between radiology and radiotherapy departments on MRI/CT image fusion, incorporating a thermomouldable cervical cushion during CT and MRI planning to optimise patient positioning.

This retrospective study analysed 200 MRI/CT co-registrations from patients treated at our institution between January 2023 and October 2024, divided into two groups: Group A (diagnostic MRI setup) and Group B (radiology/radiotherapy synergy with thermomouldable cervical cushion and laser alignment). Rotational deviations (pitch, roll, yaw) were extracted. Data were assessed for normality using the Kolmogorov-Smirnov test, and group comparisons were performed with an independent samples t-test (p < 0.05).

Group B demonstrated significantly lower absolute rotational deviations than Group A across all axes (pitch, roll, yaw; p < 0.001). Mean absolute deviations were reduced from 7.44° to 3.46° for pitch (X-axis), 2.86°-1.59° for roll (Y-axis), and 4.18°-1.70° for yaw (Z-axis), confirming the impact of radiology/radiotherapy synergy on improving MRI/CT image-fusion alignment.

Multidisciplinary cooperation between the radiology and radiotherapy departments enabled the implementation of an improved MRI acquisition protocol for SRS planning. The introduction of a thermomouldable cervical cushion provided a simple, reproducible, and accessible solution to improve MRI/CT image-fusion quality, particularly valuable in hospitals without dedicated MRI scanners for radiotherapy.

Multidisciplinary synergy between the radiology and radiotherapy departments significantly improved MRI and CT image co-registration, optimising precision in SRS planning, supported by the use of a thermomouldable cervical cushion.