The utility of multimodality imaging with CT and MRI in defining rectal tumour volumes for radiotherapy treatment planning: a pilot study

Tan, Jennifer; Joon, Daryl Lim; Fitt, Greg; Wada, M.; Joon, Michael Lim; Mercuri, Angelina; Marr, MaryAnn Dorothy; Chao, Michael; Khoo, Vincent

doi:10.1111/j.1754-9485.2010.02212.x

Cited by 38 publications

(18 citation statements)

References 14 publications

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“…For the planning of radiotherapy, magnetic resonance imaging (MRI) demonstrated its superior soft tissue contrast compared to computed tomography (CT) [4]. In the case of rectal cancer, MRI showed prognostic power for staging capabilities [5,6] and reducing the radiotherapy volumes by approximately 20% and inter-observer variability with respect to CT-based delineations [7,8].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of magnetic resonance imaging-only rectum radiotherapy with a commercial synthetic computed tomography generation solution

Maspero

Tyyger

Tijssen

et al. 2018

Physics and Imaging in Radiation Oncology

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A B S T R A C TBackground and purpose: Synthetic computed tomography (sCT) images enable magnetic resonance (MR)-based dose calculations. This work investigated whether a commercially available sCT generation solution was suitable for accurate dose calculations and position verification on patients with rectal cancer. Material and methods: For twenty rectal cancer patients computed tomography (CT) images were rigidly registered to sCT images. Clinical volumetric modulated arc therapy plans were recalculated on registered CT and sCT images. Dose deviations were determined through gamma and voxelwise analysis. The impact on position verification was investigated by identifying differences in translations and rotation between cone-beam CT (CBCT) to CT and CBCT to sCT registrations. Results: Across twenty patients, within a threshold of 90% of the prescription dose, a gamma analysis (2%, 2 mm) mean pass rate of 95.2 ± 4.0% ( ± 1 ) and mean dose deviation of −0.3 ± 0.2% of prescription dose were obtained. The mean difference of translations and rotations over ten patients (76 CBCTs) was < 1 mm and < 0.5°in all directions. In the sole posterior-anterior direction a mean systematic shift of 0.7 ± 0.6 mm was found. Conclusions: Accurate MR-based dose calculations using a commercial sCT generation method were clinically feasible for treatment of rectal cancer patients. The accuracy of position verification was clinically acceptable. However, before clinical implementation future investigations will be performed to determine the origin of the systematic shift.

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Section: Introductionmentioning

confidence: 99%

Feasibility of magnetic resonance imaging-only rectum radiotherapy with a commercial synthetic computed tomography generation solution

Maspero

Tyyger

Tijssen

et al. 2018

Physics and Imaging in Radiation Oncology

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“…Scenarios such as radiotherapy treatment planning using multimodal imaging (Kessler et al, 1991;Tan et al, 2010;Thorwarth et al, 2013) could also benefit from the advantages of the inclusion of additional regional information using OF-MI. Considering that segmentations are normally available for the dosimetry planning (Acosta et al, 2010;Bazalova and Graves, 2011;Lu et al, 2011), their use for the registration could imply benefits without affecting the clinical protocols.…”

Section: Discussionmentioning

confidence: 99%

Organ-focused mutual information for nonrigid multimodal registration of liver CT and Gd–EOB–DTPA-enhanced MRI

Fernandez-de-Manuel

Wollny

Kybic

et al. 2014

Medical Image Analysis

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Accurate detection of liver lesions is of great importance in hepatic surgery planning. Recent studies have shown that the detection rate of liver lesions is significantly higher in gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) than in contrast-enhanced portal-phase computed tomography (CT); however, the latter remains essential because of its high specificity, good performance in estimating liver volumes and better vessel visibility. To characterize liver lesions using both the above image modalities, we propose a multimodal nonrigid registration framework using organ-focused mutual information (OF-MI). This proposal tries to improve mutual information (MI) based registration by adding spatial information, benefiting from the availability of expert liver segmentation in clinical protocols. The incorporation of an additional information channel containing liver segmentation information was studied. A dataset of real clinical images and simulated images was used in the validation process. A Gd-EOB-DTPA-enhanced MRI simulation framework is presented. To evaluate results, warping index errors were calculated for the simulated data, and landmark-based and surface-based errors were calculated for the real data. An improvement of the registration accuracy for OF-MI as compared with MI was found for both simulated and real datasets. Statistical significance of the difference was tested and confirmed in the simulated dataset (p < 0.01).

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“…The GTV is the macroscopic volume of the tumor. The GTV defines the tumor volume determined by clinical examination and imaging modalities (visible, palpable) [ 19 ] .…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Tumor volumes defined on MRI are smaller, shorter, and more distal from the anal sphincter than CT-based volumes. Tan et al [ 19 ] compared the volumetric and spatial relationships of gross tumor volume (GTV) derived from CT (CT-GTV) and GTV derived from MRI (MR-GTV) to determine the utility of multimodality imaging for radiotherapy treatment planning in rectal cancer. Fifteen patients with T3-stage rectal cancer were accrued in this study.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer

Wang

Zhe

2013

Cancer Imaging

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Radiotherapy plays an important role in the treatment of rectal cancer. Three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are mainstay techniques of radiotherapy for rectal cancer. However, the success of these techniques is heavily reliant on accurate target delineation and treatment planning. Computed tomography simulation is a cornerstone of rectal cancer radiotherapy, but there are limitations, such as poor soft-tissue contrast between pelvic structures and partial volume effects. Magnetic resonance imaging and positron emission tomography (PET) can overcome these limitations and provide additional information for rectal cancer treatment planning. PET can also reduce the interobserver variation in the definition of rectal tumor volume. However, there is a long way to go before these image modalities are routinely used in the clinical setting. This review summarizes the most promising studies on clinical applications of multimodality imaging in target delineation and treatment planning for rectal cancer radiotherapy.

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The utility of multimodality imaging with CT and MRI in defining rectal tumour volumes for radiotherapy treatment planning: a pilot study

Cited by 38 publications

References 14 publications

Feasibility of magnetic resonance imaging-only rectum radiotherapy with a commercial synthetic computed tomography generation solution

Feasibility of magnetic resonance imaging-only rectum radiotherapy with a commercial synthetic computed tomography generation solution

Organ-focused mutual information for nonrigid multimodal registration of liver CT and Gd–EOB–DTPA-enhanced MRI

Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer

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