Task group 284 report: magnetic resonance imaging simulation in radiotherapy: considerations for clinical implementation, optimization, and quality assurance

Glide-Hurst, Carri K; Paulson, E.S.; McGee, Kiaran P.; Tyagi, Neetu; Hu, Yanle; Balter, James M.; Bayouth, John E.

doi:10.1002/mp.14695

Cited by 77 publications

(152 citation statements)

References 128 publications

(351 reference statements)

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“…Advanced distortion correction methods that reduce spatial distortion to acceptable tolerances across the entire imaging volume and therefore beyond the volume characterized by the DSV are needed. At a minimum for RT applications spatial fidelity needs to be maintained within ±2 mm over a DSV of 50 cm centered about the isocenter of the MR scanner and ±1 mm for stereotactic applications over a DSV of 20 cm which is consistent with the recently published report by the AAPM TG 284 committee 3 and the recommendations provided by AAPM TG 147 4 …”

Section: Major Findings and Recommendationssupporting

confidence: 74%

Findings of the AAPM Ad Hoc committee on magnetic resonance imaging in radiation therapy: Unmet needs, opportunities, and recommendations

et al. 2021

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The past decade has seen the increasing integration of magnetic resonance (MR) imaging into radiation therapy (RT). This growth can be contributed to multiple factors, including hardware and software advances that have allowed the acquisition of high-resolution volumetric data of RT patients in their treatment position (also known as MR simulation) and the development of methods to image and quantify tissue function and response to therapy. More recently, the advent of MR-guided radiation therapy (MRgRT) -achieved through the integration of MR imaging systems and linear accelerators -has further accelerated this trend. As MR imaging in RT techniques and technologies, such as MRgRT, gain regulatory approval worldwide, these systems will begin to propagate beyond tertiary care academic medical centers and into more community-based health systems and hospitals, creating new opportunities to provide advanced treatment options to a broader patient population. Accompanying these opportunities are unique challenges related to their adaptation, adoption, and use including modification of hardware and software to meet the unique and distinct demands of MR imaging in RT, the need for standardization of imaging techniques and protocols, education of the broader RT community (particularly in regards to MR safety) as well as the need to continue and support research, and development in this space. In response to this, an ad hoc committee of the American Association of Physicists in Medicine (AAPM) was formed to identify the unmet needs, roadblocks, and opportunities within this space. The purpose of this document is to report on the major findings and recommendations identified. Importantly, the provided recommendations represent the consensus opinions of the committee's membership, which were submitted in the committee's report to the AAPM Board of Directors. In addition, AAPM ad hoc committee reports differ from AAPM task group reports in that ad hoc committee reports are neither reviewed nor ultimately approved by the committee's parent groups, including at the council and executive committee level. Thus, the recommendations given in this summary should not be construed as being endorsed by or official recommendations from the AAPM.

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Section: Major Findings and Recommendationssupporting

confidence: 74%

Findings of the AAPM Ad Hoc committee on magnetic resonance imaging in radiation therapy: Unmet needs, opportunities, and recommendations

et al. 2021

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“… 9 , 10 Commissioning and QA methods for each of these steps are described in several national and international reports on conventional linacs and MRI‐simulators. 11 , 12 , 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

“…9,10 Commissioning and QA methods for each of these steps are described in several national and international reports on conventional linacs and MRI-simulators. [11][12][13][14][15][16] The Elekta Unity MR-linac (Elekta AB, Stockholm, Sweden) was cleared by the US Food and Drug Administration (FDA) for clinical use in the United States in late December 2018. This device couples a diagnostic 1.5T MRI scanner (Philips Healthcare, Best, the Netherlands) with a linear accelerator equipped with a 7 MV flattening filter-free treatment beam.…”

Section: Introductionmentioning

confidence: 99%

“…Online adaptation is comprised of numerous steps including acquisition of daily planning MRI images, rigid and deformable registration, contouring, IMRT optimization, and dose calculation in the presence of the magnetic field 9,10 . Commissioning and QA methods for each of these steps are described in several national and international reports on conventional linacs and MRI‐simulators 11–16 …”

Section: Introductionmentioning

confidence: 99%

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Longitudinal assessment of quality assurance measurements in a 1.5T MR‐linac: Part I—Linear accelerator

Subashi

Lim

Gonzalez

et al. 2021

J Applied Clin Med Phys

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To describe and report longitudinal quality assurance (QA) measurements for the mechanical and dosimetric performance of an Elekta Unity MRlinac during the first year of clinical use in our institution. Materials and methods: The mechanical and dosimetric performance of the MR-linac was evaluated with daily, weekly, monthly, and annual QA testing. The measurements monitor the size of the radiation isocenter, the MR-to-MV isocenter concordance, MLC and jaw position, the accuracy and reproducibility of step-and-shoot delivery, radiation output and beam profile constancy, and patient-specific QA for the first 50 treatments in our institution. Results from end-to-end QA using anthropomorphic phantoms are also included as a reference for baseline comparisons. Measurements were performed in water or water-equivalent plastic using ion chambers of various sizes, an ion chamber array, MR-compatible 2D/3D diode array, portal imager, MRI, and radiochromic film. Results: The diameter of the radiation isocenter and the distance between the MR/MV isocenters was (μ ± σ) 0.39 ± 0.01 mm and 0.89 ± 0.05 mm, respectively. Trend analysis shows both measurements to be well within the tolerance of 1.0 mm. MLC and jaw positional accuracy was within 1.0 mm while the dosimetric performance of step-and-shoot delivery was within 2.0%, irrespective of gantry angle. Radiation output and beam profile constancy were within 2.0% and 1.0%, respectively. End-to-end testing performed with ion-chamber and radiochromic film showed excellent agreement with treatment plan. Patient-specific QA using a 3D diode array identified gantry angles with low-pass rates allowing for improvements in plan quality after necessary adjustments. Conclusion:The MR-linac operates within the guidelines of current recommendations for linear accelerator performance, stability, and safety. The analysis of the data supports the recently published guidance in establishing clinically acceptable tolerance levels for relative and absolute measurements.

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“…Besides the normal diagnostic MRI scanner, MRgRT also involves the use of two different types of MRI scanners (Figure 1). They are the dedicated MRI-simulator (MRsim) mainly for the offline use in the MRgRT treatment planning (16)(17)(18)(19), and the MR-LINAC mainly for the online use in the MRgRT treatment fractions (8)(9)(10).…”

Section: Mri Scanners In the Mrgrtmentioning

confidence: 99%

A narrative review of MRI acquisition for MR-guided-radiotherapy in prostate cancer

Yuan¹,

Poon²,

Lo³

et al. 2022

Quant Imaging Med Surg

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Magnetic resonance guided radiotherapy (MRgRT), enabled by the clinical introduction of the integrated MRI and linear accelerator (MR-LINAC), is a novel technique for prostate cancer (PCa) treatment, promising to further improve clinical outcome and reduce toxicity. The role of prostate MRI has been greatly expanded from the traditional PCa diagnosis to also PCa screening, treatment and surveillance. Diagnostic prostate MRI has been relatively familiar in the community, particularly with the development of Prostate Imaging -Reporting and Data System (PI-RADS). But, on the other hand, the use of MRI in the emerging clinical practice of PCa MRgRT, which is substantially different from that in PCa diagnosis, has been so far sparsely presented in the medical literature. This review attempts to give a comprehensive overview of MRI acquisition techniques currently used in the clinical workflows of PCa MRgRT, from treatment planning to online treatment guidance, in order to promote MRI practice and research for PCa MRgRT. In particular, the major differences in the MRI acquisition of PCa MRgRT from that of diagnostic prostate MRI are demonstrated and explained. Limitations in the current MRI acquisition for PCa MRgRT are analyzed. The future developments of MRI in the PCa MRgRT are also discussed.

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Task group 284 report: magnetic resonance imaging simulation in radiotherapy: considerations for clinical implementation, optimization, and quality assurance

Cited by 77 publications

References 128 publications

Findings of the AAPM Ad Hoc committee on magnetic resonance imaging in radiation therapy: Unmet needs, opportunities, and recommendations

Findings of the AAPM Ad Hoc committee on magnetic resonance imaging in radiation therapy: Unmet needs, opportunities, and recommendations

Longitudinal assessment of quality assurance measurements in a 1.5T MR‐linac: Part I—Linear accelerator

A narrative review of MRI acquisition for MR-guided-radiotherapy in prostate cancer

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