Assessment of MRI image quality for various setup positions used in breast radiotherapy planning

Batumalai, Vikneswary; Liney, Gary; Delaney, Geoff P.; Rai, Roshika; Boxer, Miriam M; Min, Myo; Berry, Megan; Pham, Toan M.; Phan, Penny; Choong, Callie; Rennie, Melanie; Chan, Christine; Holloway, Lois

doi:10.1016/j.radonc.2016.02.024

Cited by 16 publications

(23 citation statements)

References 9 publications

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“…Traditionally, breast MRI is performed with the patient lying in a prone position whilst breast radiotherapy is delivered most commonly in the supine position. Previous work demonstrated comparable imaging quality with supine versus prone positioning for breast radiotherapy target delineation purposes [10]. The use of the prone position for breast radiotherapy is increasing with reported improvements in organ at risk (OAR) doses and target dose coverage [11,12].…”

Section: Introductionmentioning

confidence: 99%

The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiation therapy planning

Dundas

Pogson

Batumalai

et al. 2018

Practical Radiation Oncology

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The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiotherapy planning, Practical Radiation Oncology (2017Oncology ( ), doi: 10.1016Oncology ( /j.prro.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT Title:The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiotherapy planning. Short Title:CT/MRI Supine/Prone Breast RadiotherapyAuthor Details: Conflict of Interest Statement:The authors report a grant (no. APP1033237) from Cancer Australia and the National Breast Cancer Foundation during the conduct of this study. Dr. Pogson reports grants from University of Wollongong, during the conduct of the study.Word Count: 3642 A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT Abstract:Purpose: To evaluate the impact of MRI vs CT derived planning target volumes (PTVs), in both supine and prone positions, for whole breast (WB) radiotherapy. Methods and Materials:Four WB radiotherapy plans were generated for 28 patients, where PTVs were generated based on CT or MRI data alone in both supine and prone positions. A 6MV tangential IMRT technique was used, with plans designated as ideal, acceptable or non-compliant. Dose metrics for PTVs and OARs were compared to analyse any differences based on imaging modality (CT vs MRI) or patient position (supine vs prone).Results: With respect to imaging modality 2/11 WB_PTV dose metrics (V90% and V110%) displayed statistically significant differences, however these differences did not alter the average plan compliance rank. With respect to patient positioning, the odds of having an ideal plan vs a non-compliant plan were higher for the supine position compared to the prone position (p=0.026). The minimum distance between the seroma cavity (SC)_PTV and the chest-wall was increased with prone positioning, (p<0.001, supine and prone values 1.1 mm and 8.7 mm respectively). Heart volume was greater in the supine position (p=0.005). Heart doses were lower in the supine position than prone (p<0.01, mean doses 3.4 ± 1.55 Gy vs 4.4 ± 1.13 Gy for supine vs prone respectively). Mean lung doses met ideal dose constraints in both positions, however best spared in the prone position. The contra-lateral breast D1cc showed significantly lower doses in the supine position, (p<0.001, 4.64 Gy vs 9.51 Gy). Conclusions:Planning with PTVs generated from MRI data showed no clinically significant differences to planning with PTVs generated from CT with respect to PTV and OAR doses. Prone positioning within this study r...

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Section: Introductionmentioning

confidence: 99%

The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiation therapy planning

Dundas

Pogson

Batumalai

et al. 2018

Practical Radiation Oncology

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“…Therefore, it is necessary to develop dedicated RT immobilization equipment that is MR-compatible (i.e., non-conductive, low-density material). This equipment must also fit inside the MR bore and leave room for the MR receiver coils (e.g., flexible receiver coils in a prone breast board), while not degrading image quality (17,22). Because of the electron stream effect (ESE), further discussed in Treatment Planning for a Hybrid Machine, simulation should include the chin and upper abdominal region.…”

Section: Patient Setupmentioning

confidence: 99%

“…Because RT immobilization devices, such as the supine and prone breast boards and coil bridges, increase the gap between the patient and the receiver coils (i.e., the distance to the posterior coil located in the scanner table and to the anterior coil on top of the patient), it was initially thought that the positioning requirements for breast cancer RT might have a negative impact on MR image quality. However, multiple studies have reported good quality of MR images for breast RT in both supine and prone treatment positions acquired at 1.5-and 3.0-T MR scanners (19,21,22).…”

Section: Image Qualitymentioning

confidence: 99%

“…In studies that evaluated prone breast MRI for RT, a dedicated breast coil is usually used (19,22,24). While this coil provides optimal image quality for the breasts, it cannot capture the full body contour and all organs at risk (OARs) with adequate quality (Figure 2).…”

Section: Image Qualitymentioning

confidence: 99%

“…Placement of an anterior receiver coil on a patient in supine position could lead to deformation of the breast ( 19 ). However, coil bridges can be used as support for the coil to prevent deformation ( Figure 1 ) ( 9 , 20 – 22 ).…”

Section: Simulationmentioning

confidence: 99%

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Optimizing MR-Guided Radiotherapy for Breast Cancer Patients

et al. 2020

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Current research in radiotherapy (RT) for breast cancer is evaluating neoadjuvant as opposed to adjuvant partial breast irradiation (PBI) with the aim of reducing the volume of breast tissue irradiated and therefore the risk of late treatment-related toxicity. The development of magnetic resonance (MR)-guided RT, including dedicated MR-guided RT systems [hybrid machines combining an MR scanner with a linear accelerator (MR-linac) or 60 Co sources], could potentially reduce the irradiated volume even further by improving tumour visibility before and during each RT treatment. In this position paper, we discuss MR guidance in relation to each step of the breast RT planning and treatment pathway, focusing on the application of MR-guided RT to neoadjuvant PBI.

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The integration of MRI in radiation therapy: collaboration of radiographers and radiation therapists

Rai

Kumar

Batumalai

et al. 2017

J of Medical Radiation Sci

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The increased utilisation of magnetic resonance imaging (MRI) in radiation therapy (RT) has led to the implementation of MRI simulators for RT treatment planning and influenced the development of MRI‐guided treatment systems. There is extensive literature on the advantages of MRI for tumour volume and organ‐at‐risk delineation compared to computed tomography. MRI provides both anatomical and functional information for RT treatment planning (RTP) as well as quantitative information to assess tumour response for adaptive treatment. Despite many advantages of MRI in RT, introducing an MRI simulator into a RT department is a challenge. Collaboration between radiographers and radiation therapists is paramount in making the best use of this technology. The cross‐disciplinary training of radiographers and radiation therapists alike is an area rarely discussed; however, it is becoming an important requirement due to detailed imaging needs for advanced RT treatment techniques and with the emergence of hybrid treatment systems. This article will discuss the initial experiences of a radiation oncology department in implementing a dedicated MRI simulator for RTP, with a focus on the training required for both radiographer and RT staff. It will also address the future of MRI in RT and the implementation of MRI‐guided treatment systems, such as MRI‐Linacs, and the role of both radiation therapists and radiographers in this technology.

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Assessment of MRI image quality for various setup positions used in breast radiotherapy planning

Cited by 16 publications

References 9 publications

The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiation therapy planning

The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiation therapy planning

Optimizing MR-Guided Radiotherapy for Breast Cancer Patients

The integration of MRI in radiation therapy: collaboration of radiographers and radiation therapists

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