CT-MRI Fusion Uncertainty in Prostate Treatment Planning for Different Image Guidance Techniques

Chen, X.; Xue, Jiajia; Chen, Lejun; Buyyounouski, Mark K.; Horwitz, Eric M.; Wang, L.; Ma, C

doi:10.1016/j.ijrobp.2013.06.1901

Cited by 6 publications

(3 citation statements)

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“…Despite the ability of an MRI to identify detailed anatomical information and transfer that information onto the planning CT scan, there are inherent limitations to the transfer process itself. For example, when fusing the CT and MRI, geometric mismatching of the prostate can occur, especially when scans are taken on different days [ 16 ]. Regardless, in our CT alone cohort despite the larger CTVs observed, we identified overall very low rates of toxicity and good HRQOL outcomes.…”

Section: Discussionmentioning

confidence: 99%

Safety of stereotactic body radiation therapy for localized prostate cancer without treatment planning MRI

et al. 2022

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Background The use of treatment planning prostate MRI for Stereotactic Body Radiation Therapy (SBRT) is largely a standard, yet not all patients can receive MRI for a variety of clinical reasons. Thus, we aim to investigate the safety of patients who received CT alone based SBRT planning for the definitive treatment of localized prostate cancer. Methods Our study analyzed 3410 patients with localized prostate cancer who were treated with SBRT at a single academic institution between 2006 and 2020. Acute and late toxicity was evaluated using the Common Terminology Criteria for Adverse Events version 5.0. Expanded Prostate Cancer Index Composite (EPIC) questionnaires evaluated QOL and PSA nadir was evaluated to detect biochemical failures. Results A total of 162 patients (4.75%) received CT alone for treatment planning. The CT alone group was older relative to the MRI group (69.9 vs 67.2, p < 0.001) and had higher risk and grade disease (p < 0.001). Additionally, the CT group exhibited a trend in larger CTVs (82.56 cc vs 76.90 cc; p = 0.055), lower total radiation doses (p = 0.048), and more frequent pelvic nodal radiation versus the MRI group (p < 0.001). There were only two reported cases of Grade 3 + toxicity within the CT alone group. Quality of life data within the CT alone group revealed declines in urinary and bowel scores at one month with return to baseline at subsequent follow up. Early biochemical failure data at median time of 2.3 years revealed five failures by Phoenix definition. Conclusions While clinical differences existed between the MRI and CT alone group, we observed tolerable toxicity profiles in the CT alone cohort, which was further supported by EPIC questionnaire data. The overall clinical outcomes appear comparable in patients unable to receive MRI for their SBRT treatment plan with early clinical follow up.

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Section: Discussionmentioning

confidence: 99%

Safety of stereotactic body radiation therapy for localized prostate cancer without treatment planning MRI

et al. 2022

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“…Some of the issues precluding accurate CT-MRI coregistration are variations in rectal and bladder filling and patient position for the two scans with CT scan usually performed on a flat couch with knee support and the MRI being performed on a rounded table top unless using a dedicated MRI simulator. Chen et al 42 showed that significant fusion uncertainties of > 4 mm were seen in 8.6% (anteroposterior direction) and 11.4% (superoinferior direction) of the patients with higher difference when scans were performed on different days. Patients with gold seed markers in situ had less prostate fusion uncertainties.…”

Section: Role Of Mri In Contemporary Radiation Oncology Practicementioning

confidence: 99%

The Promise of Magnetic Resonance Imaging in Radiation Oncology Practice in the Management of Brain, Prostate, and GI Malignancies

Srinivasan

Dasgupta

Chatterjee

et al. 2022

JCO Global Oncology

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Magnetic resonance imaging (MRI) has a key role to play at multiple steps of the radiotherapy (RT) treatment planning and delivery process. Development of high-precision RT techniques such as intensity-modulated RT, stereotactic ablative RT, and particle beam therapy has enabled oncologists to escalate RT dose to the target while restricting doses to organs at risk (OAR). MRI plays a critical role in target volume delineation in various disease sites, thus ensuring that these high-precision techniques can be safely implemented. Accurate identification of gross disease has also enabled selective dose escalation as a means to widen the therapeutic index. Morphological and functional MRI sequences have also facilitated an understanding of temporal changes in target volumes and OAR during a course of RT, allowing for midtreatment volumetric and biological adaptation. The latest advancement in linear accelerator technology has led to the incorporation of an MRI scanner in the treatment unit. MRI-guided RT provides the opportunity for MRI-only workflow along with online adaptation for either target or OAR or both. MRI plays a key role in post-treatment response evaluation and is an important tool for guiding decision making. In this review, we briefly discuss the RT-related applications of MRI in the management of brain, prostate, and GI malignancies.

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“…Moreover, Debois et al [3] reported reduced inter-observer delineation variability of up to 3.5 times on CT/MRI compared to CT. However, studies have reported significant fusion uncertainties of the prostate gland on CT/MRI of up to 8mm, attributable to different-day imaging and differing pre-scan protocols [4,5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of inter- and intra-observer variations in prostate gland delineation using CT-alone versus CT/TPUS

Lim

Gacasan

Tuan

et al. 2022

Rep Pract Oncol Radiother.

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CT-MRI Fusion Uncertainty in Prostate Treatment Planning for Different Image Guidance Techniques

Cited by 6 publications

References 0 publications

Safety of stereotactic body radiation therapy for localized prostate cancer without treatment planning MRI

Safety of stereotactic body radiation therapy for localized prostate cancer without treatment planning MRI

The Promise of Magnetic Resonance Imaging in Radiation Oncology Practice in the Management of Brain, Prostate, and GI Malignancies

Evaluation of inter- and intra-observer variations in prostate gland delineation using CT-alone versus CT/TPUS

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