Magnetic resonance imaging in lung: a review of its potential for radiotherapy

Kumar, Shivani; Liney, Gary; Rai, Robba; Holloway, Lois; Moses, Daniel; Vinod, Shalini

doi:10.1259/bjr.20150431

Cited by 45 publications

(45 citation statements)

References 79 publications

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“…4 Pulmonary nodules and mediastinal disease are best assessed with a T 1 weighted (T1W) 3D gradient recall echo (GRE) sequence with breath-hold. 3 A major issue with lung imaging is the effect of respiratory motion. To minimise impact of respiratory motion, respiratory gating or a breath-hold manoeuvre is performed during image acquisition.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of free breathing Lung MRI for Radiotherapy using non-Cartesian k-space acquisition schemes

Kumar

Rai

Stemmer

et al. 2017

BJR

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Objective:To test a free-breathing MRI protocol for anatomical and functional assessment during lung cancer radiotherapy by assessing two non-Cartesian acquisition schemes based on T 1 weighted 3D gradient recall echo sequence: (i) stack-of stars (StarVIBE) and (ii) spiral (SpiralVIBE) trajectories. Methods:MR images on five healthy volunteers were acquired on a wide bore 3T scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). Anatomical image quality was assessed on: (1) free breathing (StarVIBE), (2) the standard clinical sequence (volumetric interpolated breath-hold examination, VIBE) acquired in a 20 second (s) compliant breath-hold and (3) 20 s non-compliant breath-hold. For functional assessment, StarVIBE and the current standard breath-hold time-resolved angiography with stochastic trajectories (TWIST) sequence were run as multiphase acquisitions to replicate dynamic contrast enhancement (DCE) in one healthy volunteer. The potential application of the SpiralVIBE sequence for lung parenchymal imaging was assessed on one healthy volunteer. Ten patients with lung cancer were subsequently imaged with the StarVIBE and SpiralVIBE sequences for anatomical and structural assessment. For functional assessment, free-breathing StarVIBE DCE protocol was compared with breath-hold TWIST sequences on four prior lung cancer patients with similar tumour locations. Image quality was evaluated independently and blinded to sequence information by an experienced thoracic radiologist. Results:For anatomical assessment, the compliant breath-hold VIBE sequence was better than free-breathing StarVIBE. However, in the presence of a non-compliant breath-hold, StarVIBE was superior. For functional assessment, StarVIBE outperformed the standard sequence and was shown to provide robust DCE data in the presence of motion. The ultrashort echo of the SpiralVIBE sequence enabled visualisation of lung parenchyma. Conclusion:The two non-Cartesian acquisition sequences, StarVIBE and SpiralVIBE, provide a free-breathing imaging protocol of the lung with sufficient image quality to permit anatomical, structural and functional assessment during radiotherapy. Advances in knowledge:Novel application of non-Cartesian MRI sequences for lung cancer imaging for radiotherapy. Illustration of SpiralVIBE UTE sequence as a promising sequence for lung structural imaging during lung radiotherapy. To test a free-breathing MRI protocol for anatomical and functional assessment during lung cancer radiotherapy by assessing two non-Cartesian acquisition schemes based on T 1 weighted 3D gradient recall echo sequence: (i) stack-of stars (StarVIBE) and (ii) spiral (SpiralVIBE) trajectories. Methods: MR images on five healthy volunteers were acquired on a wide bore 3T scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). Anatomical image quality was assessed on: (1) free breathing (StarVIBE), (2) the standard clinical sequence (volumetric interpolated breath-hold examination, VIBE) acquired in a 20 second (s) compliant breath-hold and ...

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Section: Discussionmentioning

confidence: 99%

Feasibility of free breathing Lung MRI for Radiotherapy using non-Cartesian k-space acquisition schemes

Kumar

Rai

Stemmer

et al. 2017

BJR

Self Cite

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“…Any method to address this fundamental limitation introduces additional uncertainties which are more pronounced for lung because lung and bone feature little MR signal. 25 Last but not least, tissue heterogeneity in lung can induce pronounced geometric distortions in MR images due to local susceptibility differences, and these errors are in addition to other MR distortions such as those due to main magnetic field and gradient field nonlinearity. 26…”

Section: B1 | Technical Limitations Of the Linac Componentmentioning

confidence: 99%

MR‐linac is the best modality for lung SBRT

Godley

Zheng

Rong

2019

J Applied Clin Med Phys

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“…This issue can particularly be a problem when body contours are needed for treatment planning (89). Newer MRI sequences have helped overcome some of these challenges; however, considerable work still needs to be done on planning and delivery systems (90). The value of functional MRI has been demonstrated by the findings of small studies looking at the utility of low ADC values on posttreatment MR images to predict local recurrence (63) and the ability of dynamic contrast-enhanced PET/MRI to assess local tumor response (91).…”

Section: Future Directionsmentioning

confidence: 99%

Stereotactic Body Radiation Therapy for Early-Stage Non–Small Cell Lung Cancer: A Primer for Radiologists

2018

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The past 2 decades have seen a rapid growth in use of stereotactic body radiation therapy (SBRT) for the management of non-small cell lung cancer (NSCLC). Not only is SBRT the reference standard for treatment of early-stage node-negative NSCLC in medically inoperable patients, it is also currently challenging the role of surgery for early-stage operable disease. SBRT is also used to treat recurrent disease and has a role in the management of multiple synchronous lung cancers. Imaging changes after SBRT differ from the changes after conventional radiation therapy in many ways, the knowledge of which is pertinent for accurate image interpretation. Posttreatment response assessment and detection of recurrent disease are heavily reliant on radiologic assessment, and often the decision to treat recurrent disease is based on the imaging findings themselves. This article provides a comprehensive review of the concepts of SBRT and the current indications for its use in the treatment of early-stage NSCLC, as well as a discussion of the CT findings seen after SBRT compared with the changes after conventional radiation therapy. Radiologic findings that are suggestive of recurrent disease and the imaging pitfalls are also highlighted. Finally, the rare complications after SBRT are described. SBRT is a major component of the changing treatment paradigms for early- and late-stage NSCLC. The imaging findings after SBRT often determine the next steps in a patient's clinical management. Therefore, radiologists must be familiar with the uses of this therapy and its radiologic appearance to be able to effectively contribute to the care of patients with NSCLC. RSNA, 2018.

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Magnetic resonance imaging in lung: a review of its potential for radiotherapy

Cited by 45 publications

References 79 publications

Feasibility of free breathing Lung MRI for Radiotherapy using non-Cartesian k-space acquisition schemes

Feasibility of free breathing Lung MRI for Radiotherapy using non-Cartesian k-space acquisition schemes

MR‐linac is the best modality for lung SBRT

Stereotactic Body Radiation Therapy for Early-Stage Non–Small Cell Lung Cancer: A Primer for Radiologists

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