Comparison of MRI with CT for the radiotherapy planning of prostate cancer: a feasibility study.

Khoo, Vincent; Padhani, Anwar R.; Tanner, Steven F.; Finnigan, David J.; Leach, Martin O.; Dearnaley, David P.

doi:10.1259/bjr.72.858.10560342

Cited by 82 publications

(49 citation statements)

References 12 publications

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“…the prostate [49], with some studies showing significantly larger target volumes delineated on CT compared with MRI [50]. This may indicate a general overestimation of target size using CT because of a lack of clinical confidence in the extent as a result of relatively poor soft-tissue contrast.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

Dean

Sykes²,

Cooper³

et al. 2012

BJR

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Objectives: MRI is the preferred staging modality for rectal carcinoma patients. This work assesses the CT-MRI co-registration accuracy of four commercial rigid-body techniques for external beam radiotherapy treatment planning for patients treated in the prone position without fiducial markers. Methods: 17 patients with biopsy-proven rectal carcinoma were scanned with CT and MRI in the prone position without the use of fiducial markers. A reference co-registration was performed by consensus of a radiologist and two physicists. This was compared with two automated and two manual techniques on two separate treatment planning systems. Accuracy and reproducibility were analysed using a measure of target registration error (TRE) that was based on the average distance of the mis-registration between vertices of the clinically relevant gross tumour volume as delineated on the CT image. Results: An automated technique achieved the greatest accuracy, with a TRE of 2.3 mm. Both automated techniques demonstrated perfect reproducibility and were significantly faster than their manual counterparts. There was a significant difference in TRE between registrations performed on the two planning systems, but there were no significant differences between the manual and automated techniques. Conclusion: For patients with rectal cancer, MRI acquired in the prone treatment position without fiducial markers can be accurately registered with planning CT. An automated registration technique offered a fast and accurate solution with associated uncertainties within acceptable treatment planning limits. Randomised trials have demonstrated that adjuvant radiotherapy (RT) in patients with resectable rectal cancer offers a statistically significant reduction in the risk of local recurrence compared with surgery alone [1]. Two meta-analyses and a systematic review have confirmed this finding [2-4]: cancer-specific survival was found to be improved when RT was delivered with biological equivalent doses of .30 Gy pre-operatively. Two further trials have confirmed similar benefit when short-course pre-operative RT was combined with total mesorectal excision (TME) [5,6].Three further randomised trials have evaluated the role of pre-operative adjuvant chemoradiotherapy (CRT) for patients with stage T3-T4 or node-positive disease. Two of these studies demonstrated a reduction in local recurrence when pre-operative adjuvant CRT was used rather than long-course adjuvant RT alone [7,8]. The third study demonstrated both reduced local recurrence and reduced acute and late toxicity for pre-operative CRT compared with post-operative CRT [9]. The Cochrane review [4] also examined CRT and concluded that CRT provided incremental benefit in local control, irrespective of the timing of the chemotherapy. These results have led to a significant increase in the use of pre-operative radiation for patients with rectal cancer.MRI offers increased soft-tissue contrast compared with other radiographic imaging modalities such as CT. This improvement allows the accurate...

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Section: Discussionmentioning

confidence: 99%

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

Dean

Sykes²,

Cooper³

et al. 2012

BJR

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“…A first order approach in the use of MR images for planning is simply to ignore tissue inhomogeneities as such, and assign a bulk density equal to 1.0 g/cm 3 to the entire body volume. The influence of this approach on the calculation of dose distributions has been investigated for treatment planning of prostate cancer and brain tumors [6,7,10,11].…”

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confidence: 99%

A simulation of MRI based dose calculations on the basis of radiotherapy planning CT images

et al. 2008

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A systematic study using segmented MR images was undertaken. To achieve an acceptable accuracy in the CTV dose, the MR images should be segmented into bone and water equivalent tissue. Still, significant dose deviation for the organs at risk may be present. As tissue segmentation in real MR images is introduced, segmentation errors and errors that stem from geometrical non-linearities may further reduce the accuracy.

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“…There are several reasons to expect that MRI would have advantages over other techniques for localizing the prostatic apex, such as the possibility to generate directly images in sagittal and coronal planes and the better soft tissue contrast. This hypothesis has been confirmed by previous studies suggesting sagittal or coronal MRI being the optimal method of localizing the prostatic apex [1,4,9,13,14,18]. Especially Milosevic et al [13] have found sagittal MRI to be beneficial for the apex definition as compared to axial CT.…”

Section: Discussionmentioning

confidence: 56%

Interobserver Comparison of CT and MRI-Based Prostate Apex Definition

Wachter

Wachter-Gerstner

Böck

et al. 2002

Strahlentherapie und Onkologie

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Additional MRI provides a superior anatomic information especially in the apical portion of the prostate. It should be recommended for every single patient in the treatment planning process. It helps to avoid an unnecessary irradiation of healthy tissue and could lead to a decrease of anal side effects and radiation-induced impotency due to a reduction of the extent of irradiated penile structures.

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Comparison of MRI with CT for the radiotherapy planning of prostate cancer: a feasibility study.

Cited by 82 publications

References 12 publications

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

An evaluation of four CT–MRI co-registration techniques for radiotherapy treatment planning of prone rectal cancer patients

A simulation of MRI based dose calculations on the basis of radiotherapy planning CT images

Interobserver Comparison of CT and MRI-Based Prostate Apex Definition

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