Characterizing spatiotemporal information loss in sparse‐sampling‐based dynamic MRI for monitoring respiration‐induced tumor motion in radiotherapy

Arai, Tatsuya; Nofiele, Joris; Madhuranthakam, Ananth J.; Yuan, Qing; Pedrosa, Iván; Chopra, Rajiv; Sawant, Amit

doi:10.1118/1.4948684

Cited by 3 publications

(5 citation statements)

References 54 publications

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“…Our current interplay effect evaluation from breathing motion is based on 4D-CT. More sophisticated representation of patient breathing motion can be achieved using new techniques such as cine-MRI [78][79][80][81] or 4D MRI [82][83][84] with finer time resolution. These MRI-based approaches provide more precise respiratory motion modeling and therefore the resulting anatomical changes.…”

Section: Discussionmentioning

confidence: 99%

Intensity‐modulated proton therapy (IMPT) interplay effect evaluation of asymmetric breathing with simultaneous uncertainty considerations in patients with non‐small cell lung cancer

et al. 2020

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Purpose Intensity‐modulated proton therapy (IMPT) is sensitive to uncertainties from patient setup and proton beam range, as well as interplay effect. In addition, respiratory motion may vary from cycle to cycle, and also from day to day. These uncertainties can severely degrade the original plan quality and potentially affect patient’s outcome. In this work, we developed a new tool to comprehensively consider the impact of all these uncertainties and provide plan robustness evaluation under them. Methods We developed a comprehensive plan robustness evaluation tool that considered both uncertainties from patient setup and proton beam range, as well as respiratory motion simultaneously. To mimic patients' respiratory motion, the time spent in each phase was randomly sampled based on patient‐specific breathing pattern parameters as acquired during the four‐dimensional (4D)‐computed tomography (CT) simulation. Spots were then assigned to one specific phase according to the temporal relationship between spot delivery sequence and patients’ respiratory motion. Dose in each phase was calculated by summing contributions from all the spots delivered in that phase. The final 4D dynamic dose was obtained by deforming all doses in each phase to the maximum exhalation phase. Three hundred (300) scenarios (10 different breathing patterns with 30 different setup and range uncertainty scenario combinations) were calculated for each plan. The dose‐volume histograms (DVHs) band method was used to assess plan robustness. Benchmarking the tool as an application’s example, we compared plan robustness under both three‐dimensional (3D) and 4D robustly optimized IMPT plans for 10 nonrandomly selected patients with non‐small cell lung cancer. Results The developed comprehensive plan robustness tool had been successfully applied to compare the plan robustness between 3D and 4D robustly optimized IMPT plans for 10 lung cancer patients. In the presence of interplay effect with uncertainties considered simultaneously, 4D robustly optimized plans provided significantly better CTV coverage (D95%, P = 0.002), CTV homogeneity (D5%‐D95%, P = 0.002) with less target hot spots (D5%, P = 0.002), and target coverage robustness (CTV D95% bandwidth, P = 0.004) compared to 3D robustly optimized plans. Superior dose sparing of normal lung (lung Dmean, P = 0.020) favoring 4D plans and comparable normal tissue sparing including esophagus, heart, and spinal cord for both 3D and 4D plans were observed. The calculation time for all patients included in this study was 11.4 ± 2.6 min. Conclusion A comprehensive plan robustness evaluation tool was successfully developed and benchmarked for plan robustness evaluation in the presence of interplay effect, setup and range uncertainties. The very high efficiency of this tool marks its clinical adaptation, highly practical and versatile nature, including possible real‐time intra‐fractional interplay effect evaluation as a potential application for future use.

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Section: Discussionmentioning

confidence: 99%

Intensity‐modulated proton therapy (IMPT) interplay effect evaluation of asymmetric breathing with simultaneous uncertainty considerations in patients with non‐small cell lung cancer

et al. 2020

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“…Thus, a navigator‐triggered/binned 4DMRI has higher image quality with fewer and less severe binning artifacts . Furthermore, MRI provides the option of the nonaxial scanning direction, such as sagittal or coronal scans, which are more desirable for characterizing tumor/organ respiratory motion . Therefore, 4DMRI promises to be clinically beneficial in assessing respiratory‐induced tumor motion …”

Section: Introductionmentioning

confidence: 99%

“…Although normal lung has low MR signal from the “air‐diluted” soft tissue, a lung tumor usually has higher density and produces sufficient MR signal, including lung tumor perfusion with dynamic contrast enhancement imaging and lung tumor microenvironment with diffusion‐weighted imaging . In lung tumor motion assessment and monitoring, dynamic two‐dimensional (2D) cine imaging has been widely applied, including MR‐guided radiotherapy, automatic tumor contouring for motion tracking, and tumor motion variation during radiotherapy . A fast field echo with either balanced steady‐state free precession or T1‐weighted (T1w) 2D cine has been used to achieve 4 Hz frame rate …”

Section: Introductionmentioning

confidence: 99%

“…In lung tumor motion assessment and monitoring, dynamic two‐dimensional (2D) cine imaging has been widely applied, including MR‐guided radiotherapy, automatic tumor contouring for motion tracking, and tumor motion variation during radiotherapy . A fast field echo with either balanced steady‐state free precession or T1‐weighted (T1w) 2D cine has been used to achieve 4 Hz frame rate …”

Section: Introductionmentioning

confidence: 99%

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Clinical evaluation of 4D MRI in the delineation of gross and internal tumor volumes in comparison with 4DCT

Zhang

Srivastava

Wang

et al. 2019

J Applied Clin Med Phys

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Purpose To evaluate clinical utility of respiratory‐correlated (RC) four‐dimensional magnetic resonance imaging (4DMRI) for lung tumor delineation and motion assessment, in comparison with the current clinical standard of 4D computed tomography (4DCT). Methods and Materials A prospective T2‐weighted (T2w) RC‐4DMRI technique was applied to acquire coronal 4DMRI images for 14 lung cancer patients (16 lesions) during free breathing (FB) under an IRB‐approved protocol, together with a breath‐hold (BH) T1w 3DMRI and axial 4DMRI. Clinical simulation CT and 4DCT were acquired within 2 h. An internal navigator was applied to trigger amplitude‐binned 4DMRI acquisition whereas a bellows or real‐time position management (RPM) was used in the 4DCT reconstruction. Six radiation oncologists manually delineated the gross and internal tumor volumes (GTV and ITV) in 399 3D images using programmed clinical workflows under a tumor delineation guideline. The ITV was the union of GTVs within the breathing cycle without margin. Average GTV and motion range were assessed and ITV variation between 4DMRI and 4DCT was evaluated using the Dice similarity index, mean distance agreement (MDA), and volume difference. Results The mean tumor volume is similar between 4DCT (GTV4DCT = 1.0, as the reference) and T2w‐4DMRI (GTVT2wMR = 0.97), but smaller in T1w MRI (GTVT1wMR = 0.76), suggesting possible peripheral edema around the tumor. Average GTV variation within the breathing cycle (22%) in 4DMRI is slightly greater than 4DCT (17%). GTV motion variation (−4 to 12 mm) and ITV variation (∆VITV=−25 to 95%) between 4DCT and 4DMRI are large, confirmed by relatively low ITV similarity (Dice = 0.72 ± 0.11) and large MDA = 2.9 ± 1.5 mm. Conclusion Average GTVs are similar between T2w‐4DMRI and 4DCT, but smaller by 25% in T1w BH MRI. Physician training and breathing coaching may be necessary to reduce ITV variability between 4DMRI and 4DCT. Four‐dimensional magnetic resonance imaging is a promising and viable technique for clinical lung tumor delineation and motion assessment.

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“…For clinical application, in order to be temporally efficient enough for the requirement of on‐board imaging, usually single or limited number of sparsely sampled MR images was acquired during radiation treatment to monitor the target motion . To accurately capture the target motion during radiation treatments, some proposed to use the target motion in 2D cine MRI, either directly or through a 2D to 3D image registration, to estimate and reconstruct the 3D motion of the tumor.…”

Section: Introductionmentioning

confidence: 99%

Principal component analysis‐based imaging angle determination for 3D motion monitoring using single‐slice on‐board imaging

et al. 2018

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Characterizing spatiotemporal information loss in sparse‐sampling‐based dynamic MRI for monitoring respiration‐induced tumor motion in radiotherapy

Cited by 3 publications

References 54 publications

Intensity‐modulated proton therapy (IMPT) interplay effect evaluation of asymmetric breathing with simultaneous uncertainty considerations in patients with non‐small cell lung cancer

Intensity‐modulated proton therapy (IMPT) interplay effect evaluation of asymmetric breathing with simultaneous uncertainty considerations in patients with non‐small cell lung cancer

Clinical evaluation of 4D MRI in the delineation of gross and internal tumor volumes in comparison with 4DCT

Principal component analysis‐based imaging angle determination for 3D motion monitoring using single‐slice on‐board imaging

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