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Huang LX, Wu XB, Liu YA, Guo X, Liu CC, Cai WQ, Wang SW, Luo B. High-resolution magnetic resonance vessel wall imaging in ischemic stroke and carotid artery atherosclerotic stenosis: A review. Heliyon 2024; 10:e27948. [PMID: 38571643 PMCID: PMC10987942 DOI: 10.1016/j.heliyon.2024.e27948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/02/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
Ischemic stroke is a significant burden on human health worldwide. Carotid Atherosclerosis stenosis plays an important role in the comprehensive assessment and prevention of ischemic stroke patients. High-resolution vessel wall magnetic resonance imaging has emerged as a successful technique for assessing carotid atherosclerosis stenosis. This advanced imaging modality has shown promise in effectively displaying a wide range of characteristics associated with the condition, leading to a comprehensive evaluation. High-resolution vessel wall magnetic resonance imaging not only enables a comprehensive evaluation of the instability of carotid atherosclerosis stenosis plaques but also provides valuable information for understanding the pathogenesis and predicting the prognosis of ischemic stroke patients. The purpose of this article is to review the application of high-resolution magnetic resonance imaging in ischemic stroke and carotid atherosclerotic stenosis.
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Affiliation(s)
- Li-Xin Huang
- Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xiao-Bing Wu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi-Ao Liu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xin Guo
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Chi-Chen Liu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Wang-Qing Cai
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sheng-Wen Wang
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Luo
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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Singhrao K, Fu J, Parikh NR, Mikaeilian AG, Ruan D, Kishan AU, Lewis JH. A generative adversarial network‐based (GAN‐based) architecture for automatic fiducial marker detection in prostate MRI‐only radiotherapy simulation images. Med Phys 2020; 47:6405-6413. [DOI: 10.1002/mp.14498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/02/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022] Open
Affiliation(s)
- Kamal Singhrao
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - Jie Fu
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - Neil R. Parikh
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - Argin G. Mikaeilian
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - Dan Ruan
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - Amar U. Kishan
- Department of Radiation Oncology University of California, Los Angeles Los Angeles CA 90095 USA
| | - John H. Lewis
- Department of Radiation Oncology Cedars‐Sinai Medical Center Los Angeles CA 90048 USA
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Tanaka O, Maejima R, Yama E, Taniguchi T, Ono K, Makita C, Matsuo M. Radiotherapy for prostate cancer: Effect of gold fiducial markers on diffusion-weighted magnetic resonance imaging. Asia Pac J Clin Oncol 2020; 17:79-83. [PMID: 32969171 DOI: 10.1111/ajco.13409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/28/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE There has been an increase in the use of gold fiducial markers to ensure precise radiotherapy delivery in prostate cancer patients. However, metal artifacts may affect the quality of subsequent imaging used to assess disease status following treatment. In this study, we evaluated the effect of gold fiducial markers on magnetic resonance imaging (MRI), particularly on diffusion-weighted imaging (DWI). MATERIAL AND METHODS Among 57 patients with prostate cancer, 21 patients in whom two gold markers were placed in the prostate tumor with abnormal signal intensity on DWI were evaluated. The effect of the markers on DWI was evaluated on a scale of 1-5, with a high score indicating clinical usefulness. Change inapparent diffusion coefficient (ADC; 10-3 mm2 /s) from before to after marker placement was also evaluated. RESULTS The mean effect of the markers on DWI was 4.3 (standard deviation [SD] 1.3, range 2-5) points. The mean change in ADC was 0.045 (SD 0.041, range 0.025-0.089) × 10-3 mm2 /s. CONCLUSIONS The gold fiducial markers demonstrated negligible effect on DWI quality. Therefore, gold markers do not affect MRI quality, particularly DWI, and may be used during follow-up in prostate cancer patients.
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Affiliation(s)
- Osamu Tanaka
- Department of Radiation Oncology, Asahi University Hospital, Gifu, Japan
| | - Ryoshu Maejima
- Department of Radiation Oncology, Asahi University Hospital, Gifu, Japan
| | - Eiichi Yama
- Division of Radiation Service, Gifu Municipal Hospital, Gifu, Japan
| | - Takuya Taniguchi
- Department of Radiation Oncology, Asahi University Hospital, Gifu, Japan
| | - Kousei Ono
- Department of Radiation Oncology, Asahi University Hospital, Gifu, Japan
| | - Chiyoko Makita
- Department of Radiology, Gifu University Hospital, Gifu, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University Hospital, Gifu, Japan
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Gilchrist S, Kinchesh P, Zarghami N, Khrapitchev AA, Sibson NR, Kersemans V, Smart SC. Improved detection of molecularly targeted iron oxide particles in mouse brain using B 0 field stabilised high resolution MRI. Magn Reson Imaging 2020; 67:101-108. [PMID: 31935444 PMCID: PMC7049896 DOI: 10.1016/j.mri.2020.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE High resolution multi-gradient echo (MGE) scanning is typically used for detection of molecularly targeted iron oxide particles. The images of individual echoes are often combined to generate a composite image with improved SNR from the early echoes and boosted contrast from later echoes. In 3D implementations prolonged scanning at high gradient duty cycles induces a B0 shift that predominantly affects image alignment in the slow phase encoding dimension of 3D MGE images. The effect corrupts the composite echo image and limits the image resolution that is realised. A real-time adaptive B0 stabilisation during respiration gated 3D MGE scanning is shown to reduce image misalignment and improve detection of molecularly targeted iron oxide particles in composite images of the mouse brain. METHODS An optional B0 measurement block consisting of a 16 μs hard pulse with FA 1°, an acquisition delay of 3.2 ms, followed by gradient spoiling in all three axes was added to a respiration gated 3D MGE scan. During the acquisition delay of each B0 measurement block the NMR signal was routed to a custom built B0 stabilisation unit which mixed the signal to an audio frequency nominally centred around 1000 Hz to enable an Arduino based single channel receiver to measure frequency shifts. The frequency shift was used to effect correction to the main magnetic field via the B0 coil. The efficacy of B0 stabilisation and respiration gating was validated in vivo and used to improve detection of molecularly targeted microparticles of iron oxide (MPIO) in a mouse model of acute neuroinflammation. RESULTS Without B0 stabilisation 3D MGE image data exhibit varying mixtures of translation, scaling and blurring, which compromise the fidelity of the composite image. The real-time adaptive B0 stabilisation minimises corruption of the composite image as the images from the different echoes are properly aligned. The improved detection of molecularly targeted MPIO easily compensates for the scan time penalty of 14% incurred by the B0 stabilisation method employed. Respiration gating of the B0 measurement and the MRI scan was required to preserve high resolution detail, especially towards the back of the brain. CONCLUSIONS High resolution imaging for the detection of molecularly targeted iron oxide particles in the mouse brain requires good stabilisation of the main B0 field, and can benefit from a respiration gated image acquisition strategy.
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Affiliation(s)
- Stuart Gilchrist
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom.
| | - Paul Kinchesh
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
| | - Niloufar Zarghami
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
| | - Alexandre A Khrapitchev
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
| | - Nicola R Sibson
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
| | - Veerle Kersemans
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
| | - Sean C Smart
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom
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Singhrao K, Ruan D, Fu J, Gao Y, Chee G, Yang Y, King C, Hu P, Kishan AU, Lewis JH. Quantification of fiducial marker visibility for MRI-only prostate radiotherapy simulation. Phys Med Biol 2020; 65:035015. [PMID: 31881546 DOI: 10.1088/1361-6560/ab65db] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
To objectively compare the suitability of MRI pulse sequences and commercially available fiducial markers (FMs) for MRI-only prostate radiotherapy simulation. Most FMs appear as small signal voids in MRI images making them difficult to differentiate from tissue heterogeneities such as calcifications. In this study we use quantitative metrics to objectively evaluate the visibility of FMs in 27 patients and an anthropomorphic phantom with a variety of standard clinical MRI pulse sequences and commercially available FMs. FM visibility was quantified using the local contrast-to-noise-ratio (lCNR), the difference between the 80th and 20th percentile iso-intensity FM volumes (V fall) and the largest iso-intensity volume that can be distinguished from background: apparent-marker-volume (AMV). A larger lCNR and AMV, and smaller V fall represents a more easily identifiable FM. The number of non-marker objects visualized by each pulse sequence was calculated using FM-derived template-matching. The FM-based target-registration-error (TRE) between each MRI and the planning-CT image was calculated. Fiducial marker visibility was rated by two medical physicists with over three years of experience examining MRI-only prostate simulation images. The rater's classification accuracy was quantified using the F 1 score, which is the harmonic mean of the rater's precision and recall. These quantitative metrics and human observer ratings were used to evaluate FM identifiability in images from nine subtypes of T 1-weighted, T 2-weighted and gradient echo (GRE) pulse sequences in a 27-patient study. A phantom study was conducted to quantify the visibility of 8 commercially available FMs. In the patient study, the largest mean lCNR and AMV and, smallest normalized V fall were produced by the 3.0 T multiple-echo GRE pulse sequence (T 1-VIBE, 2° flip angle, 1.23 ms and 2.45 ms echo-times). This pulse sequence produced no false marker detections and TREs less than 2 mm in the left-right, anterior-posterior and cranial-caudal directions, respectively. Human observers rated the 1.23 ms echo-time GRE images with the best average marker visibility score of 100% and an F 1 score of 1. In the phantom study, the Gold-Anchor GA-200X-20-B (deployed in a folded configuration) produced the largest sequence averaged lCNR and AMV measurements at 16.1 and 16.7 mm3, respectively. Using quantitative visibility and distinguishability metrics and human observer ratings, the patient study demonstrated that multiple-echo GRE images produced the best gold FM visibility and distinguishability. The phantom study demonstrated that markers manufactured from platinum or iron-doped gold quantitatively produced superior visibility compared to their pure gold counterparts.
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Affiliation(s)
- Kamal Singhrao
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA 90095, United States of America
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de Muinck Keizer DM, Pathmanathan AU, Andreychenko A, Kerkmeijer LGW, van der Voort van Zyp JRN, Tree AC, van den Berg CAT, de Boer JCJ. Fiducial marker based intra-fraction motion assessment on cine-MR for MR-linac treatment of prostate cancer. Phys Med Biol 2019; 64:07NT02. [PMID: 30794995 DOI: 10.1088/1361-6560/ab09a6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We have developed a method to determine intrafraction motion of the prostate through automatic fiducial marker (FM) tracking on 3D cine-magnetic resonance (MR) images with high spatial and temporal resolution. Twenty-nine patients undergoing prostate stereotactic body radiotherapy (SBRT), with four implanted cylindrical gold FMs, had cine-MR imaging sessions after each of five weekly fractions. Each cine-MR examination consisted of 55 sequentially obtained 3D datasets ('dynamics'), acquired over a 11 s period, covering a total of 10 min. FM locations in the first dynamic were manually identified by a clinician, FM centers in subsequent dynamics were automatically determined. Center of mass (COM) translations and rotations were determined by calculating the rigid transformations between the FM template of the first and subsequent dynamics. The algorithm was applied to 7315 dynamics over 133 scans of 29 patients and the obtained results were validated by comparing the COM locations recorded by the clinician at the halfway-dynamic (after 5 min) and end dynamic (after 10 min). The mean COM translations at 10 min were X: 0.0 [Formula: see text] 0.8 mm, Y: 1.0 [Formula: see text] 1.9 mm and Z: 0.9 [Formula: see text] 2.0 mm. The mean rotation results at 10 min were X: 0.1 [Formula: see text] 3.9°, Y: 0.0 [Formula: see text] 1.3° and Z: 0.1 [Formula: see text] 1.2°. The tracking success rate was 97.7% with a mean 3D COM error of 1.1 mm. We have developed a robust, fast and accurate FM tracking algorithm for cine-MR data, which allows for continuous monitoring of prostate motion during MR-guided radiotherapy (MRgRT). These results will be used to validate automatic prostate tracking based on soft-tissue contrast.
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Affiliation(s)
- D M de Muinck Keizer
- Department of Radiotherapy, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. Joint first author. Author to whom any correspondence should be addressed
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Pathmanathan AU, McNair HA, Schmidt MA, Brand DH, Delacroix L, Eccles CL, Gordon A, Herbert T, van As NJ, Huddart RA, Tree AC. Comparison of prostate delineation on multimodality imaging for MR-guided radiotherapy. Br J Radiol 2019; 92:20180948. [PMID: 30676772 PMCID: PMC6540870 DOI: 10.1259/bjr.20180948] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE: With increasing incorporation of MRI in radiotherapy, we investigate two MRI sequences for prostate delineation in radiographer-led image guidance. METHODS: Five therapeutic radiographers contoured the prostate individually on CT, T2 weighted (T2W) and T2* weighted (T2*W) imaging for 10 patients. Contours were analysed with Monaco ADMIRE (research v. 2.0) to assess interobserver variability and accuracy by comparison with a gold standard clinician contour. Observers recorded time taken for contouring and scored image quality and confidence in contouring. RESULTS: There is good agreement when comparing radiographer contours to the gold-standard for all three imaging types with Dice similarity co-efficient 0.91-0.94, Cohen's κ 0.85-0.91, Hausdorff distance 4.6-7.6 mm and mean distance between contours 0.9-1.2 mm. In addition, there is good concordance between radiographers across all imaging modalities. Both T2W and T2*W MRI show reduced interobserver variability and improved accuracy compared to CT, this was statistically significant for T2*W imaging compared to CT across all four comparison metrics. Comparing MRI sequences reveals significantly reduced interobserver variability and significantly improved accuracy on T2*W compared to T2W MRI for DSC and Cohen's κ. Both MRI sequences scored significantly higher compared to CT for image quality and confidence in contouring, particularly T2*W. This was also reflected in the shorter time for contouring, measuring 15.4, 9.6 and 9.8 min for CT, T2W and T2*W MRI respectively. Conclusion: Therapeutic radiographer prostate contours are more accurate, show less interobserver variability and are more confidently and quickly outlined on MRI compared to CT, particularly using T2*W MRI. Advances in knowledge: Our work is relevant for MRI sequence choice and development of the roles of the interprofessional team in the advancement of MRI-guided radiotherapy.
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Affiliation(s)
| | - Helen A McNair
- The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, United Kingdom
| | | | | | - Louise Delacroix
- The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, United Kingdom
| | | | - Alexandra Gordon
- The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, United Kingdom
| | - Trina Herbert
- The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, United Kingdom
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Pathmanathan AU, Schmidt MA, Brand DH, Kousi E, van As NJ, Tree AC. Improving fiducial and prostate capsule visualization for radiotherapy planning using MRI. J Appl Clin Med Phys 2019; 20:27-36. [PMID: 30756456 PMCID: PMC6414142 DOI: 10.1002/acm2.12529] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/06/2018] [Accepted: 12/10/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Intraprostatic fiducial markers (FM) improve the accuracy of radiotherapy (RT) delivery. Here we assess geometric integrity and contouring consistency using a T2*-weighted (T2*W) sequence alone, which allows visualization of the FM. MATERIAL AND METHODS Ten patients scanned within the Prostate Advances in Comparative Evidence (PACE) trial (NCT01584258) had prostate images acquired with computed tomography (CT) and Magnetic Resonance (MR) Imaging: T2-weighted (T2W) and T2*W sequences. The prostate was contoured independently on each imaging dataset by three clinicians. Interobserver variability was assessed using comparison indices with Monaco ADMIRE (research version 2.0, Elekta AB) and examined for statistical differences between imaging sets. CT and MR images of two test objects were acquired to assess geometric distortion and accuracy of marker positioning. The first was a linear test object comprising straight tubes in three orthogonal directions, the second was a smaller test object with markers suspended in gel. RESULTS Interobserver variability for prostate contouring was lower for both T2W and T2*W compared to CT, this was statistically significant when comparing CT and T2*W images. All markers are visible in T2*W images with 29/30 correctly identified, only 3/30 are visible in T2W images. Assessment of geometric distortion revealed in-plane displacements were under 0.375 mm in MRI, and through plane displacements could not be detected. The signal loss in the MR images is symmetric in relation to the true marker position shown in CT images. CONCLUSION Prostate T2*W images are geometrically accurate, and yield consistent prostate contours. This single sequence can be used to identify FM and for prostate delineation in a mixed MR-CT workflow.
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Affiliation(s)
- Angela U Pathmanathan
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Maria A Schmidt
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Douglas H Brand
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Evanthia Kousi
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Nicholas J van As
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | - Alison C Tree
- The Royal Marsden Hospital NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
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Cheng VWT, Soto MS, Khrapitchev AA, Perez-Balderas F, Zakaria R, Jenkinson MD, Middleton MR, Sibson NR. VCAM-1-targeted MRI Enables Detection of Brain Micrometastases from Different Primary Tumors. Clin Cancer Res 2019; 25:533-543. [PMID: 30389659 DOI: 10.1158/1078-0432.ccr-18-1889] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/06/2018] [Accepted: 10/30/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE A major issue for the effective treatment of brain metastasis is the late stage of diagnosis with existing clinical tools. The aim of this study was to evaluate the potential of vascular cell adhesion molecule 1 (VCAM-1)-targeted MRI for early detection of brain micrometastases in mouse models across multiple primary tumor types.Experimental Design: Xenograft models of brain micrometastasis for human breast carcinoma (MDA231Br-GFP), lung adenocarcinoma (SEBTA-001), and melanoma (H1_DL2) were established via intracardiac injection in mice. Animals (n = 5-6/group) were injected intravenously with VCAM-1-targeted microparticles of iron oxide (VCAM-MPIO) and, subsequently, underwent T 2*-weighted MRI. Control groups of naïve mice injected with VCAM-MPIO and tumor-bearing mice injected with nontargeting IgG-MPIO were included. RESULTS All models showed disseminated micrometastases in the brain, together with endothelial VCAM-1 upregulation across the time course. T 2*-weighted MRI of all tumor-bearing mice injected with VCAM-MPIO showed significantly more signal hypointensities (P < 0.001; two-sided) than control cohorts, despite a lack of blood-brain barrier (BBB) impairment. Specific MPIO binding to VCAM-1-positive tumor-associated vessels was confirmed histologically. VCAM-1 expression was demonstrated in human brain metastasis samples, across all three primary tumor types. CONCLUSIONS VCAM-1-targeted MRI enables the detection of brain micrometastases from the three primary tumor types known to cause the majority of clinical cases. These findings represent an important step forward in the development of a broadly applicable and clinically relevant imaging technique for early diagnosis of brain metastasis, with significant implications for improved patient survival.
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Affiliation(s)
- Vinton W T Cheng
- Department of Oncology, Cancer Research UK and Medical Research Council, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Manuel Sarmiento Soto
- Department of Oncology, Cancer Research UK and Medical Research Council, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
- Department of Biochemistry and Molecular Biology, University of Seville, Seville, Spain
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Alexandre A Khrapitchev
- Department of Oncology, Cancer Research UK and Medical Research Council, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Francisco Perez-Balderas
- Department of Oncology, Cancer Research UK and Medical Research Council, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Rasheed Zakaria
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Mark R Middleton
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Nicola R Sibson
- Department of Oncology, Cancer Research UK and Medical Research Council, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom.
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van den Ende RPJ, Rigter LS, Kerkhof EM, van Persijn van Meerten EL, Rijkmans EC, Lambregts DMJ, van Triest B, van Leerdam ME, Staring M, Marijnen CAM, van der Heide UA. MRI visibility of gold fiducial markers for image-guided radiotherapy of rectal cancer. Radiother Oncol 2018; 132:93-99. [PMID: 30825976 DOI: 10.1016/j.radonc.2018.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/29/2018] [Accepted: 11/25/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE A GTV boost is suggested to result in higher complete response rates in rectal cancer patients, which is attractive for organ preservation. Fiducials may offer GTV position verification on (CB)CT, if the fiducial-GTV spatial relationship can be accurately defined on MRI. The study aim was to evaluate the MRI visibility of fiducials inserted in the rectum. MATERIALS AND METHODS We tested four fiducial types (two Visicoil types, Cook and Gold Anchor), inserted in five patients each. Four observers identified fiducial locations on two MRI exams per patient in two scenarios: without (scenario A) and with (scenario B) (CB)CT available. A fiducial was defined to be consistently identified if 3 out of 4 observers labeled that fiducial at the same position on MRI. Fiducial visibility was scored on an axial and sagittal T2-TSE sequence and a T1 3D GRE sequence. RESULTS Fiducial identification was poor in scenario A for all fiducial types. The Visicoil 0.75 and Gold Anchor were the most consistently identified fiducials in scenario B with 7 out of 9 and 8 out of 11 consistently identified fiducials in the first MRI exam and 2 out of 7 and 5 out of 10 in the second MRI exam, respectively. The consistently identified Visicoil 0.75 and Gold Anchor fiducials were best visible on the T1 3D GRE sequence. CONCLUSION The Visicoil 0.75 and Gold Anchor fiducials were the most visible fiducials on MRI as they were most consistently identified. The use of a registered (CB)CT and a T1 3D GRE MRI sequence is recommended.
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Affiliation(s)
- Roy P J van den Ende
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands.
| | - Lisanne S Rigter
- Department of Gastroenterology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ellen M Kerkhof
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
| | | | - Eva C Rijkmans
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Baukelien van Triest
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Monique E van Leerdam
- Department of Gastroenterology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marius Staring
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Corrie A M Marijnen
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
| | - Uulke A van der Heide
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands; Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
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11
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Evaluation of a free-breathing respiratory-triggered (Navigator) 3-D T1-weighted (T1W) gradient recalled echo sequence (LAVA) for detection of enhancement in cystic and solid renal masses. Eur Radiol 2018; 29:2507-2517. [PMID: 30506224 DOI: 10.1007/s00330-018-5839-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/15/2018] [Accepted: 10/17/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To evaluate free-breathing Navigator-triggered 3-D T1-weighted MRI (NAV-LAVA) compared to breath-hold (BH)-LAVA among cystic and solid renal masses. MATERIALS AND METHODS With an IRB waiver, 44 patients with 105 renal masses (71 non-enhancing cysts and 14 cystic and 20 solid renal masses) underwent MRI between 2016 and 2017 where BH-LAVA and NAV-LAVA were performed. Subtraction images were generated for BH-LAVA and NAV-LAVA using pre- and 3-min post-gadolinium-enhanced images and were evaluated by two blinded radiologists for overall image quality, image sharpness, motion artifact, and quality of subtraction (using 5-point Likert scales) and presence/absence of enhancement. Percentage signal intensity change (Δ%SI) = ([SI.post-gadolinium-SI.pre-gadolinium]/SI.pre-gadolinium)*100, was measured on BH-LAVA and NAV-LAVA. Likert scores were compared using Wilcoxon's sign-rank test and accuracy for detection of enhancement compared using receiver operator characteristic (ROC) analysis. RESULTS Overall image quality (p = 0.002-0.141), image sharpness (p = 0.002-0.031), and motion artifact were better (p = 0.002) comparing BH-LAVA to NAV-LAVA for both radiologists; however, quality of image subtraction did not differ between groups (p = 0.09-0.14). Sensitivity/specificity/area under ROC curve for enhancement in cystic and solid renal masses using subtraction and %SIΔ were (1) BH-LAVA: 64.7%/98.6%/0.82 (radiologist 1), 61.8%/95.8%/0.79 (radiologist 2), and 70.6%/81.7%/0.76 (%SIΔ) versus 2) NAV-LAVA: 58.8%/95.8%/0.79 (radiologist 1, p = 0.16), 58.8%/88.7%/0.73 (radiologist 2, p = 0.37), and 73.5%/76.1%/0.75 (%SIΔ, p = 0.74). CONCLUSIONS NAV-LAVA showed similar quality of subtraction and ability to detect enhancement compared to BH-LAVA in renal masses albeit with lower image quality, image sharpness, and increased motion artifact. NAV-LAVA may be considered in renal MRI for patients where BH is suboptimal. KEY POINTS • Free-breathing Navigator (NAV) 3-D subtraction MRI is comparable to breath-hold (BH) images. • Accuracy for subjective and quantitative diagnosis of enhancement in renal masses on NAV 3-D T1W is comparable to BH MRI. • NAV 3-D T1W renal MRI is useful in patients who may not be able to adequately BH.
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McNabb E, Wong R, Noseworthy MD. Resolution and registration in dual-plane co-RASOR MR. Phys Med Biol 2018; 63:215005. [PMID: 30260799 DOI: 10.1088/1361-6560/aae4d5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Magnetic resonance imaging (MRI) has superior soft tissue contrast and lower interobserver variability compared to computed tomography and advances in equipment and pseudo-CT estimation have allowed for MR-only radiation therapy planning. Dedicated MR sequences have been used to localize paramagnetic structures with positive contrast, and most implanted seeds are gold fiducial markers (GFMs). We used a fast, dual-plane co-RASOR sequence to localize implanted GFMs with positive contrast in phantom and tissue to assess their resolution and registration accuracy of registration to CT. Off-resonant reconstructions of co-RASOR images were able to resolve GFMs down to 5 mm apart at 12 cm FOV. No systematic biases were observed by comparing registration of co-RASOR and bSSFP to CT images in an MR-compatible Lego phantom with a set of highly visible known points. The standard deviations of the MR to CT distance errors were <0.5 mm in all directions. We separated the component due to registration by comparing the two MR sequences, which had a maximum standard deviation of 0.36 mm in the SI-direction. Registration using the positive contrast points in a porcine sample phantom showed increased errors, but co-RASOR still performs acceptably with a target registration error of <0.75 mm. The dual-plane co-RASOR sequence could then be used for both registration and image tracking when performing MR-only radiation therapy planning.
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Affiliation(s)
- Evan McNabb
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
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Zarghami N, Khrapitchev AA, Perez-Balderas F, Soto MS, Larkin JR, Bau L, Sibson NR. Optimization of molecularly targeted MRI in the brain: empirical comparison of sequences and particles. Int J Nanomedicine 2018; 13:4345-4359. [PMID: 30100719 PMCID: PMC6064157 DOI: 10.2147/ijn.s158071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Molecular MRI is an evolving field of research with strong translational potential. Selection of the appropriate MRI sequence, field strength and contrast agent depend largely on the application. The primary aims of the current study were to: 1) assess the sensitivity of different MRI sequences for detection of iron oxide particles in mouse brain; 2) determine the effect of magnetic field strength on detection of iron oxide particles in vivo; and 3) compare the sensitivity of targeted microparticles of iron oxide (MPIO) or ultra-small superparamagnetic iron oxide (USPIO) for detection of vascular cell adhesion molecule-1 (VCAM-1) in vivo. METHODS Mice were injected intrastriatally with interleukin 1β to induce VCAM-1 expression on the cerebral vasculature. Subsequently, animals were injected intravenously with either VCAM-MPIO or VCAM-USPIO and imaged 1 or 13 hours post-injection, respectively. MRI was performed at 4.7, 7.0, or 9.4 T, using three different T2*-weighted sequences: single gradient echo 3D (GE3D), multi-gradient echo 3D (MGE3D) and balanced steady-state free precession 3D (bSSFP3D). RESULTS MGE3D yielded the highest signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the detection of iron oxide particles. All sequences showed a significant increase in SNR and CNR from 4.7 to 7.0 T, but no further improvement at 9.4 T. However, whilst targeted MPIO enabled sensitive detection of VCAM-1 expression on the cerebral vasculature, the long half-life (16.5 h vs 1.2 min) and lower relaxivity per particle (1.29×10-14 vs 1.18×10-9 Hz L/particle) of USPIO vs. MPIO rendered them impractical for molecular MRI. CONCLUSION These findings demonstrate clear advantages of MPIO compared to USPIO for molecularly-targeted MRI, and indicate that the MGE3D sequence is optimal for MPIO detection. Moreover, higher field strengths (7.0/9.4 T) showed enhanced sensitivity over lower field strengths (4.7 T). With the development of biodegradable MPIO, these agents hold promise for clinical translation.
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Affiliation(s)
- Niloufar Zarghami
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Alexandre A Khrapitchev
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Francisco Perez-Balderas
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Manuel Sarmiento Soto
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - James R Larkin
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Luca Bau
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
| | - Nicola R Sibson
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
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Dirajlal PA, Jambon E, Albat-Esquirou A, Galmiche C, Bernhard JC, Grenier N, Haaser T, Cornelis FH. T2 Star-weighted Angiography (SWAN) Allows to Concomitantly Assess the Prostate Contour While Detecting Fiducials Before MR-based Intensity-modulated Radiation Therapy in Prostate Carcinoma. Acad Radiol 2018; 25:95-101. [PMID: 28844603 DOI: 10.1016/j.acra.2017.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the performance of T2 star-weighted angiography (SWAN) to concomitantly assess the prostate contour while detecting fiducials before magnetic resonance (MR)-based intensity-modulated radiation therapy (IMRT) in prostate carcinoma. MATERIALS AND METHODS Forty patients (mean age: 73.1 ± 7.5 years; average Gleason score: 7 ± 1; average prostate-specific antigen: 14.7 ± 11.6 ng/mL) underwent MR and computed tomography imaging before fiducial-based IMRT. MR protocol included SWAN, T2-weighted (T2w) and diffusion-weighted imaging in a first group (n = 20) and SWAN, T2w and T2-star weighted imaging in a second group (n = 20). In group 1, the depiction of fiducials, image sharpness and visibility of prostate boundaries were independently evaluated by 2 readers on SWAN, T2w or diffusion-weighted images. In group 2, a similar evaluation was performed by 2 other readers on SWAN and T2-star images only. Depiction of fiducials was compared to computed tomography findings. RESULTS The median scores of visibility of prostate boundaries, image sharpness and depiction of fiducials by SWAN were above average to excellent for all readers. In group 1, readers correctly located 56 of 57 (98.2%) and 47 of 57 (82.5%) fiducials, respectively; and 50 of 51 (98%), and 48 of 51 (88.2%) fiducials in group 2, respectively. CONCLUSION By allowing adequate visualization of the prostate boundaries and high depiction of fiducial markers concomitantly, SWAN might be used for treatment planning of IMRT. The use of this sequence might simplify the registration process and limit any errors associated with image fusion.
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Affiliation(s)
| | - Eva Jambon
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | - Agnes Albat-Esquirou
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | - Chloe Galmiche
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | | | - Nicolas Grenier
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | - Thibaud Haaser
- Department of Oncology, St André Hospital, Bordeaux, France
| | - François H Cornelis
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France; Department of Radiology, Tenon Hospital, 4 rue de la Chine, 75020 Paris, France.
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Tanaka O, Komeda H, Hattori M, Hirose S, Yama E, Matsuo M. Comparison of MRI sequences in ideal fiducial maker-based radiotherapy for prostate cancer. Rep Pract Oncol Radiother 2017; 22:502-506. [PMID: 29123458 DOI: 10.1016/j.rpor.2017.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/11/2017] [Accepted: 10/07/2017] [Indexed: 12/31/2022] Open
Abstract
Aim Prostate contouring using CT alone is difficult. To overcome the uncertainty, CT/MRI registration using a fiducial marker is generally performed. However, visualization of the marker itself can be difficult with MRI. This study aimed to determine the optimal MRI pulse sequence for defining the marker as well as the prostate outline among five sequences. Materials and methods A total of 21 consecutive patients with prostate cancer were enrolled. Two gold fiducial markers were placed before CT/MRI examination. We used the following five sequences: T1-weighted spin-echo (T1WI; TR/TE, 400-650/8 ms); T2-weighted fast spin-echo (T2WI; 4000/80); T2*-2D-weighted gradient echo (T2*2D; 700/18); T2*-3D-weighted gradient echo (T2*3D; TR/TE1/deltaTE, 37/14/7.3); and contrast-enhanced T1-weighted spin-echo (CE-T1WI; 400-650/8). Qualitative image analysis of the sequences was performed by three observers. These observers subjectively scored all images on a scale of 1-3 (1 = unclear, 2 = moderate, 3 = well visualized). A higher score indicated better visualization. Results T2WI was significantly superior to the other sequences in terms of prostate definition. T2*2D and T2*3D were strongly superior to the other sequences and were significantly superior in terms of fiducial marker definition. Conclusions T2*2D and T2*3D are superior to the other sequences for prostate contouring and marker identification. Therefore, we recommend initial T2*3D and T2*2D examinations.
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Affiliation(s)
- Osamu Tanaka
- Department of Radiation Oncology, Gifu Municipal Hospital, Japan
| | - Hisao Komeda
- Department of Urology, Gifu Municipal Hospital, Japan
| | | | - Shigeki Hirose
- Department of Radiation Oncology, Gifu Municipal Hospital, Japan
| | - Eiichi Yama
- Department of Radiation Oncology, Gifu Municipal Hospital, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University School of Medicine, Japan
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Maspero M, van den Berg CAT, Zijlstra F, Sikkes GG, de Boer HCJ, Meijer GJ, Kerkmeijer LGW, Viergever MA, Lagendijk JJW, Seevinck PR. Evaluation of an automatic MR-based gold fiducial marker localisation method for MR-only prostate radiotherapy. ACTA ACUST UNITED AC 2017; 62:7981-8002. [DOI: 10.1088/1361-6560/aa875f] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Gustafsson C, Korhonen J, Persson E, Gunnlaugsson A, Nyholm T, Olsson LE. Registration free automatic identification of gold fiducial markers in MRI target delineation images for prostate radiotherapy. Med Phys 2017; 44:5563-5574. [DOI: 10.1002/mp.12516] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/14/2017] [Accepted: 08/06/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Christian Gustafsson
- Department of Hematology, Oncology and Radiation Physics; Skåne University Hospital; Lund 221 85 Sweden
- Department of Medical Radiation Physics; Lund University; Malmö 205 02 Sweden
| | - Juha Korhonen
- Department of Nuclear Medicine; Helsinki University Central Hospital; Helsinki 00290 Finland
- Department of Radiology; Helsinki University Central Hospital; Helsinki 00290 Finland
- Department of Radiation Therapy; Comprehensive Cancer Center; Helsinki University Central Hospital; Helsinki 00290 Finland
| | - Emilia Persson
- Department of Hematology, Oncology and Radiation Physics; Skåne University Hospital; Lund 221 85 Sweden
- Department of Medical Radiation Physics; Lund University; Malmö 205 02 Sweden
| | - Adalsteinn Gunnlaugsson
- Department of Hematology, Oncology and Radiation Physics; Skåne University Hospital; Lund 221 85 Sweden
| | - Tufve Nyholm
- Department of Radiation Sciences; Umeå University; Umeå 90187 Sweden
- Department of Immunology, Genetics and Pathology; Uppsala University; Uppsala 95105 Sweden
| | - Lars E. Olsson
- Department of Medical Radiation Physics; Lund University; Malmö 205 02 Sweden
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Magnetic resonance imaging in prostate brachytherapy: Evidence, clinical end points to data, and direction forward. Brachytherapy 2017; 16:659-664. [PMID: 28161432 DOI: 10.1016/j.brachy.2016.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 11/21/2022]
Abstract
The integration of multiparametric MRI into prostate brachytherapy has become a subject of interest over the past 2 decades. MRI directed high-dose-rate and low-dose-rate prostate brachytherapy offers the potential to improve treatment accuracy and standardize postprocedure quality. This article reviews the evidence to date on MRI utilization in prostate brachytherapy and postulates future pathways for MRI integration.
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Dinis Fernandes C, Dinh CV, Steggerda MJ, ter Beek LC, Smolic M, van Buuren LD, Pos FJ, van der Heide UA. Prostate fiducial marker detection with the use of multi-parametric magnetic resonance imaging. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2017. [DOI: 10.1016/j.phro.2017.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fiducial marker for prostate radiotherapy: comparison of 0.35- and 0.5-mm-diameter computed tomography and magnetic resonance images. Radiol Med 2016; 122:204-207. [DOI: 10.1007/s11547-016-0715-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/27/2016] [Indexed: 12/31/2022]
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Lim C, Malone SC, Avruch L, Breau RH, Flood TA, Lim M, Morash C, Quon JS, Walsh C, Schieda N. Pictorial review. Magnetic resonance for radiotherapy management and treatment planning in prostatic carcinoma. Br J Radiol 2015; 88:20150507. [PMID: 26279086 DOI: 10.1259/bjr.20150507] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
MRI has an important role for radiotherapy (RT) treatment planning in prostate cancer (PCa) providing accurate visualization of the dominant intraprostatic lesion (DIL) and locoregional anatomy, assessment of local staging and depiction of implanted devices. MRI enables the radiation oncologist to optimize RT planning by better defining target tumour volumes (thereby increasing local tumour control), as well as decreasing morbidity (by minimizing the dose to adjacent normal structures). Using MRI, radiation oncologists can define the DIL for delivery of boost doses of RT using a variety of techniques including: stereotactic body radiotherapy, intensity-modulated radiotherapy, proton RT or brachytherapy to improve tumour control. Radiologists require a familiarity with the different RT methods used to treat PCa, as well as an understanding of the advantages and disadvantages of the various MR pulse sequences available for RT planning in order to provide an optimal multidisciplinary RT treatment approach to PCa. Understanding the expected post-RT appearance of the prostate and typical characteristics of local tumour recurrence is also important because MRI is rapidly becoming an integral component for diagnosis, image-guided histological sampling and treatment planning in the setting of biochemical failure after RT or surgery.
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Affiliation(s)
- Christopher Lim
- 1 Department of Medical Imaging The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Shawn C Malone
- 2 Department of Radiation Oncology, The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Leonard Avruch
- 1 Department of Medical Imaging The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Rodney H Breau
- 3 Department of Surgery, Division of Urology, The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Trevor A Flood
- 4 Department of Anatomical Pathology, The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Megan Lim
- 5 Faculty of Medicine, The University of Saskatchewan, Saskatoon, SK, Canada
| | - Christopher Morash
- 3 Department of Surgery, Division of Urology, The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Jeff S Quon
- 1 Department of Medical Imaging The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Cynthia Walsh
- 1 Department of Medical Imaging The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
| | - Nicola Schieda
- 1 Department of Medical Imaging The Ottawa Hospital, The University of Ottawa, Ottawa, ON, Canada
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