Purpose MRI‐based treatment planning is a promising technique for liver stereotactic‐body radiation therapy (SBRT) treatment planning to improve target volume delineation and reduce radiation dose to normal tissues. MR geometric distortion, however, is a source of potential error in MRI‐based treatment planning. The aim of this study is to investigate dosimetric uncertainties caused by MRI geometric distortion in MRI‐based treatment planning for liver SBRT.Materials and MethodsThe study was conducted using computer simulations. 3D MR geometric distortion was simulated using measured data in the literature. Planning MR images with distortions were generated by integrating the simulated 3D MR geometric distortion onto planning CT images. MRI‐based treatment plans were then generated on the planning MR images with two dose calculation methods: (1) using original CT numbers; and (2) using organ‐specific assigned CT numbers. Dosimetric uncertainties of various dose‐volume‐histogram parameters were determined as their differences between the simulated MRI‐based plans and the original clinical CT‐based plans for five liver SBRT cases.ResultsThe average simulated distortion for the five liver SBRT cases was 2.77 mm. In the case of using original CT numbers for dose calculation, the average dose uncertainties for target volumes and critical structures were <0.5 Gy, and the average target volume percentage at prescription dose uncertainties was 0.97%. In the case of using assigned CT numbers, the average dose uncertainties for target volumes and critical structures were <1.0 Gy, and the average target volume percentage at prescription dose uncertainties was 2.02%.ConclusionsDosimetric uncertainties caused by MR geometric distortion in MRI‐based liver SBRT treatment planning was generally small (<1 Gy) when the distortion is 3 mm.

Background: To investigate the feasibility of generating maximum intensity projection (MIP) images to determine internal target volume (ITV) using slice-stacking MRI (SS-MRI) technique.Methods: Slice-stacking is a technique which applies a multi-slice MRI acquisition to generate a 3D MIP for ITV contouring, without reconstructing 4D-MRI. 4D digital extended cardiac-torso (XCAT) phantom was used to generate MIP images with sequential 2D HASTE sequence, with different tumor diameters (10, 30 and 50 mm) and with simulated regular and irregular (patient) breathing motions. A reference MIP was generated using all acquisition images. Consecutive repetitions were then used to generate MIP to analyze the relationship between Dice's similarity coefficient (DSC) and the number of repetitions, and the relationship between the relative ITV volume difference and the number of repetitions. Images from XCAT phantom and from three hepatic carcinoma patients were collected in this study to demonstrate the feasibility of this technique.Results: For both regular and irregular breathing motion, the average DSC of ITV is >0.94 and the average relative ITV volume difference is <10% (approximately 0.15 cm 3 ) when using 5 repeated scanning images to reconstruct MIP for tumor diameter of 10 mm. As tumor diameter increases, the DSC of ITV is >0.97 and the relative ITV volume difference is <5% for regular breathing motion, and the DSC of ITV is >0.97 and the relative ITV volume difference is <5.5% for irregular breathing motion when using 5 repeated scanning images to reconstruct MIP. In patient image study, the mean relative ITV volume difference is <3% and the mean DSC is 0.99 when using 5 repeated scanning images to reconstruct MIP. Conclusions:The number of scans required to generate tumor ITV for slice-stacking method (5-7 repetition) is 3-4 times less than that of . It is feasible to generate a fast clinically acceptable ITV using slice-stacking method with sequential 2D MR images.

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