1
|
Li G, Liu Y, Nie X. Respiratory-Correlated (RC) vs. Time-Resolved (TR) Four-Dimensional Magnetic Resonance Imaging (4DMRI) for Radiotherapy of Thoracic and Abdominal Cancer. Front Oncol 2019; 9:1024. [PMID: 31681573 PMCID: PMC6798178 DOI: 10.3389/fonc.2019.01024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/23/2019] [Indexed: 12/25/2022] Open
Abstract
Recent technological and clinical advancements of both respiratory-correlated (RC) and time-resolved (TR) four-dimensional magnetic resonance imaging (4DMRI) techniques are reviewed in light of tumor/organ motion simulation, monitoring, and assessment in radiotherapy. For radiotherapy of thoracic and abdominal cancer, respiratory-induced tumor motion, and motion variation due to breathing irregularities are the major uncertainties in treatment. RC-4DMRI is developed to assess tumor motion for treatment planning, whereas TR-4DMRI is developed to assess both motion and motion variation for treatment planning, delivery and assessment. RC-4DMRI is reconstructed to provide one-breathing-cycle motion, similar to 4D computed tomography (4DCT), the current clinical standard, but with higher soft-tissue contrast, no ionizing radiation, and less binning artifacts due to the use of an internal respiratory surrogate. Recent studies have shown that its spatial resolution has reached or exceeded that of 4DCT and scanning time becomes clinically acceptable. TR-4DMRI is recently developed with an adequate spatiotemporal resolution to assess tumor motion and motion variations for treatment simulation, delivery and assessment. The super-resolution approach is most promising since it can image any organ/body motion, whereas RC-4D MRI are limited to resolve only respiration-induced motion and some TR-4DMRI approaches may more or less depend on RC-4DMRI. TR-4DMRI provides multi-breath motion data that are useful not only in MR-guided radiotherapy but also for building a patient-specific motion model to guide radiotherapy treatment using an non-MR-equipped linear accelerator. Based on 4DMRI motion data, motion-corrected dynamic contrast imaging and diffusion-weighted imaging have also been reported, aiming to facilitate tumor delineation for more accurate radiotherapy targeting. Both RC- and TR-4DMRI have been evaluated for potential clinical applications, such as delineation of tumor volumes, where sufficiently high spatial resolution and large field-of-view are required. The 4DMRI techniques are promising to play a role in motion assessment in radiotherapy treatment planning, delivery, assessment, and adaptation.
Collapse
Affiliation(s)
- Guang Li
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | | |
Collapse
|
2
|
Kim T, Park JC, Gach HM, Chun J, Mutic S. Technical Note: Real‐time 3D MRI in the presence of motion for MRI‐guided radiotherapy: 3D Dynamic keyhole imaging with super‐resolution. Med Phys 2019; 46:4631-4638. [DOI: 10.1002/mp.13748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/21/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Taeho Kim
- Department of Radiation Oncology Washington University School of Medicine St Louis MO 63110USA
| | - Justin C. Park
- Department of Radiation Oncology Washington University School of Medicine St Louis MO 63110USA
| | - H. Michael Gach
- Department of Radiation Oncology Washington University School of Medicine St Louis MO 63110USA
- Department of Radiology and Biomedical Engineering Washington University in St. Louis St Louis MO 63110USA
| | - Jaehee Chun
- Department of Radiation Oncology Yonsei University College of Medicine Seoul 03722South Korea
| | - Sasa Mutic
- Department of Radiation Oncology Washington University School of Medicine St Louis MO 63110USA
| |
Collapse
|
3
|
Menten MJ, Wetscherek A, Fast MF. MRI-guided lung SBRT: Present and future developments. Phys Med 2017; 44:139-149. [PMID: 28242140 DOI: 10.1016/j.ejmp.2017.02.003] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/25/2017] [Accepted: 02/07/2017] [Indexed: 12/25/2022] Open
Abstract
Stereotactic body radiotherapy (SBRT) is rapidly becoming an alternative to surgery for the treatment of early-stage non-small cell lung cancer patients. Lung SBRT is administered in a hypo-fractionated, conformal manner, delivering high doses to the target. To avoid normal-tissue toxicity, it is crucial to limit the exposure of nearby healthy organs-at-risk (OAR). Current image-guided radiotherapy strategies for lung SBRT are mostly based on X-ray imaging modalities. Although still in its infancy, magnetic resonance imaging (MRI) guidance for lung SBRT is not exposure-limited and MRI promises to improve crucial soft-tissue contrast. Looking beyond anatomical imaging, functional MRI is expected to inform treatment decisions and adaptations in the future. This review summarises and discusses how MRI could be advantageous to the different links of the radiotherapy treatment chain for lung SBRT: diagnosis and staging, tumour and OAR delineation, treatment planning, and inter- or intrafractional motion management. Special emphasis is placed on a new generation of hybrid MRI treatment devices and their potential for real-time adaptive radiotherapy.
Collapse
Affiliation(s)
- Martin J Menten
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK.
| | - Andreas Wetscherek
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Martin F Fast
- Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK.
| |
Collapse
|
4
|
Brandner ED, Chetty IJ, Giaddui TG, Xiao Y, Huq MS. Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: A review from NRG oncology. Med Phys 2017; 44:2595-2612. [PMID: 28317123 DOI: 10.1002/mp.12227] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/23/2017] [Accepted: 03/10/2017] [Indexed: 12/11/2022] Open
Abstract
The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper, we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient-specific situations. Some of the recommendations will potentially be adopted to guide clinical trial protocols.
Collapse
Affiliation(s)
- Edward D Brandner
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, PA, 15232, USA
| | - Indrin J Chetty
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Tawfik G Giaddui
- Sidney Kimmel Cancer Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Ying Xiao
- Imaging and Radiation Oncology Core (IROC), University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - M Saiful Huq
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, PA, 15232, USA
| |
Collapse
|
5
|
Pollard JM, Wen Z, Sadagopan R, Wang J, Ibbott GS. The future of image-guided radiotherapy will be MR guided. Br J Radiol 2017; 90:20160667. [PMID: 28256898 DOI: 10.1259/bjr.20160667] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Advances in image-guided radiotherapy (RT) have allowed for dose escalation and more precise radiation treatment delivery. Each decade brings new imaging technologies to help improve RT patient setup. Currently, the most frequently used method of three-dimensional pre-treatment image verification is performed with cone beam CT. However, more recent developments have provided RT with the ability to have on-board MRI coupled to the teleradiotherapy unit. This latest tool for treating cancer is known as MR-guided RT. Several varieties of these units have been designed and installed in centres across the globe. Their prevalence, history, advantages and disadvantages are discussed in this review article. In preparation for the next generation of image-guided RT, this review also covers where MR-guided RT might be heading in the near future.
Collapse
Affiliation(s)
| | - Zhifei Wen
- UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jihong Wang
- UT MD Anderson Cancer Center, Houston, TX, USA
| | | |
Collapse
|
6
|
Panek R, Schmidt MA, Borri M, Koh DM, Riddell A, Welsh L, Dunlop A, Powell C, Bhide SA, Nutting CM, Harrington KJ, Newbold KL, Leach MO. Time-resolved angiography with stochastic trajectories for dynamic contrast-enhanced MRI in head and neck cancer: Are pharmacokinetic parameters affected? Med Phys 2016; 43:6024. [PMID: 27806585 DOI: 10.1118/1.4964795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/26/2016] [Accepted: 09/30/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To investigate the effects of different time-resolved angiography with stochastic trajectories (TWIST) k-space undersampling schemes on calculated pharmacokinetic dynamic contrast-enhanced (DCE) vascular parameters. METHODS A digital perfusion phantom was employed to simulate effects of TWIST on characteristics of signal changes in DCE. Furthermore, DCE-MRI was acquired without undersampling in a group of patients with head and neck squamous cell carcinoma and used to simulate a range of TWIST schemes. Errors were calculated as differences between reference and TWIST-simulated DCE parameters. Parametrical error maps were used to display the averaged results from all tumors. RESULTS For a relatively wide range of undersampling schemes, errors in pharmacokinetic parameters due to TWIST were under 10% for the volume transfer constant, Ktrans, and total extracellular extravascular space volume, Ve. TWIST induced errors in the total blood plasma volume, Vp, were the largest observed, and these were inversely dependent on the area of the fully sampled k-space. The magnitudes of errors were not correlated with Ktrans, Vp and weakly correlated with Ve. CONCLUSIONS The authors demonstrated methods to validate and optimize k-space view-sharing techniques for pharmacokinetic DCE studies using a range of clinically relevant spatial and temporal patient derived data. The authors found a range of undersampling patterns for which the TWIST sequence can be reliably used in pharmacokinetic DCE-MRI. The parameter maps created in the study can help to make a decision between temporal and spatial resolution demands and the quality of enhancement curve characterization.
Collapse
Affiliation(s)
- Rafal Panek
- CR-UK Cancer Imaging Centre, London SM2 5PT, United Kingdom; The Institute of Cancer Research, London SM2 5PT, United Kingdom; and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Maria A Schmidt
- CR-UK Cancer Imaging Centre, London SM2 5PT, United Kingdom; The Institute of Cancer Research, London SM2 5PT, United Kingdom; and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Marco Borri
- CR-UK Cancer Imaging Centre, London SM2 5PT, United Kingdom; The Institute of Cancer Research, London SM2 5PT, United Kingdom; and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Dow-Mu Koh
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Angela Riddell
- The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Liam Welsh
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Alex Dunlop
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Ceri Powell
- The Institute of Cancer Research, London SM2 5PT, United Kingdom
| | - Shreerang A Bhide
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Christopher M Nutting
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Kevin J Harrington
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Kate L Newbold
- The Institute of Cancer Research, London SM2 5PT, United Kingdom and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| | - Martin O Leach
- CR-UK Cancer Imaging Centre, London SM2 5PT, United Kingdom; The Institute of Cancer Research, London SM2 5PT, United Kingdom; and The Royal Marsden NHS Trust, London SM2 5PT, United Kingdom
| |
Collapse
|