MRI integration into treatment planning of head and neck tumors: Can patient immobilization be avoided?

Fortunati, Valerio; Verhaart, René F.; Verduijn, Gerda M.; Lugt, Aad van der; Angeloni, Francesco; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; Walsum, Theo van

doi:10.1016/j.radonc.2015.03.021

Cited by 20 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In personalized RT, treatment adaptation based on PET/MR information could be of particular relevance. However, data integration requires precise alignment with the RT planning CT. Advanced strategies like deformable image registration are available and may yield reasonable results [39] , but multimodal alignment is more precise if both examinations are conducted in RT position, especially for head-and-neck [27] . The purpose of this study was to assess feasibility and image quality of a dedicated hardware solution for PET/MRI in treatment position.…”

Section: Discussionmentioning

confidence: 99%

“…The integration of combined PET/MRI into RT, however, requires patient examination in RT position for accurate image alignment with the RT planning CT [6] , [24] , [25] , [26] , [27] . Especially for HNC, it has been shown that the accuracy of rigid or deformable registration algorithms is strongly improved when patient images are acquired in RT position for both CT and MRI [26] , [27] . The adaptation to treatment position, on the other hand, is challenging as it requires RT immobilization equipment to be combined with the MRI hardware, in particular with the radiofrequency coils used for signal reception.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Assessment of image quality of a radiotherapy-specific hardware solution for PET/MRI in head and neck cancer patients

Winter

Leibfarth

Schmidt

et al. 2018

Radiotherapy and Oncology

View full text Add to dashboard Cite

Background and purposeFunctional PET/MRI has great potential to improve radiotherapy planning (RTP). However, data integration requires imaging with radiotherapy-specific patient positioning. Here, we investigated the feasibility and image quality of radiotherapy-customized PET/MRI in head-and-neck cancer (HNC) patients using a dedicated hardware setup.Material and methodsTen HNC patients were examined with simultaneous PET/MRI before treatment, with radiotherapy and diagnostic scan setup, respectively. We tested feasibility of radiotherapy-specific patient positioning and compared the image quality between both setups by pairwise image analysis of 18F-FDG-PET, T1/T2-weighted and diffusion-weighted MRI. For image quality assessment, similarity measures including average symmetric surface distance (ASSD) of PET and MR-based tumor contours, MR signal-to-noise ratio (SNR) and mean apparent diffusion coefficient (ADC) value were used.ResultsPET/MRI in radiotherapy position was feasible – all patients were successfully examined. ASSD (median/range) of PET and MR contours was 0.6 (0.4–1.2) and 0.9 (0.5–1.3) mm, respectively. For T2-weighted MRI, a reduced SNR of −26.2% (−39.0–−11.7) was observed with radiotherapy setup. No significant difference in mean ADC was found.ConclusionsSimultaneous PET/MRI in HNC patients using radiotherapy positioning aids is clinically feasible. Though SNR was reduced, the image quality obtained with a radiotherapy setup meets RTP requirements and the data can thus be used for personalized RTP.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Assessment of image quality of a radiotherapy-specific hardware solution for PET/MRI in head and neck cancer patients

Winter

Leibfarth

Schmidt

et al. 2018

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

“…For rigid registration to be optimal, the patient's anatomy on MRI should match that on CT. Improvement in registration accuracy can be achieved when patient immobilisation and setup is consistent across the two modalities [8][9][10] . Despite efforts to reproduce patient position between scans, there may be difficulties performing rigid registration of MRI to CT images.…”

Section: Data Processing Registrationmentioning

confidence: 99%

Guidance on the use of MRI for treatment planning in radiotherapy clinical trials

Johnstone

Urbano

Michaelidou

et al. 2019

The British Journal of Radiology

View full text Add to dashboard Cite

The aim of this article is to propose meaningful guidance covering the technical and safety issues involved when designing or conducting radiotherapy clinical trials that use MRI for treatment planning. The complexity of imaging requirements will depend on the trial aims, design and MRI methods used. The use of MRI within the RT pathway is becoming more prevalent and clinically appropriate as access to MRI increases, treatment planning systems become more versatile and potential indications for MRI-planning in RT are documented. Novel MRI-planning opportunities are often initiated and validated within clinical trials. The guidance in this document is intended to assist researchers designing RT clinical trials involving MRI, so that they may provide sufficient information about the appropriate methods to be used for image acquisition, post-processing and quality assurance such that participating sites complete MRI to consistent standards. It has been produced in collaboration with the National Radiotherapy Trials Quality Assurance Group (RTTQA). As the use of MRI in RT is developed, it is highly recommended for researchers writing clinical trial protocols to include imaging guidance as part of their clinical trial documentation covering the trial-specific requirements for MRI procedures. Many of the considerations and recommendations in this guidance may well apply to MR-guided treatment machines, where clinical trials will be crucial. Similarly, many of these recommendations will apply to the general use of MRI in RT, outside of clinical trials. This document contains a large number of recommendations, not all of which will be relevant to any particular trial. Designers of RT clinical trials must therefore take this into account. They must also use their own judgement as to the appropriate compromise between accessibility of the trial and its technical rigour.

show abstract

“…For the integration of PET/MRI into RT planning, precise image fusion of PET/MRI and planning CT is mandatory. For this purpose, patient examination in RT position is essential, especially in the case of head and neck [17]. Image analysis of the first ten patients recruited in this clinical trial demonstrated the clinical feasibility of functional PET/MRI examination in RT-specific position using a customized hardware setup.…”

Section: Discussionmentioning

confidence: 87%

Distortion correction of diffusion-weighted magnetic resonance imaging of the head and neck in radiotherapy position

et al. 2017

View full text Add to dashboard Cite

MRI integration into treatment planning of head and neck tumors: Can patient immobilization be avoided?

Cited by 20 publications

References 24 publications

Assessment of image quality of a radiotherapy-specific hardware solution for PET/MRI in head and neck cancer patients

Assessment of image quality of a radiotherapy-specific hardware solution for PET/MRI in head and neck cancer patients

Guidance on the use of MRI for treatment planning in radiotherapy clinical trials

Distortion correction of diffusion-weighted magnetic resonance imaging of the head and neck in radiotherapy position

Contact Info

Product

Resources

About