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Patient-specific quality assurance strategies for synthetic computed tomography in magnetic resonance-only radiotherapy of the abdomen.


ABSTRACT:

Background and purpose

The superior tissue contrast of magnetic resonance (MR) compared to computed tomography (CT) led to an increasing interest towards MR-only radiotherapy. For the latter, the dose calculation should be performed on a synthetic CT (sCT). Patient-specific quality assurance (PSQA) methods have not been established yet and this study aimed to assess several software-based solutions.

Materials and methods

A retrospective study was performed on 20 patients treated at an MR-Linac, which were selected to evenly cover four subcategories: (i) standard, (ii) air pockets, (iii) lung and (iv) implant cases. The neural network (NN) CycleGAN was adopted to generate a reference sCT, which was then compared to four PSQA methods: (A) water override of body, (B) five tissue classes with bulk densities, (C) sCT generated by a separate NN (pix2pix) and (D) deformed CT.

Results

The evaluation of the dose endpoints demonstrated that while all methods A-D provided statistically equivalent results (p = 0.05) within the 2% level for the standard cases (i), only the methods C-D guaranteed the same result over the whole cohort. The bulk densities override was shown to be a valuable method in absence of lung tissue within the beam path.

Conclusion

The observations of this study suggested that the use of an additional sCT generated by a separate NN was an appropriate tool to perform PSQA of a sCT in an MR-only workflow at an MR-Linac. The time and dose endpoints requirements were respected, namely within 10 min and 2%.

SUBMITTER: Dal Bello R 

PROVIDER: S-EPMC10366576 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Patient-specific quality assurance strategies for synthetic computed tomography in magnetic resonance-only radiotherapy of the abdomen.

Dal Bello Riccardo R   Lapaeva Mariia M   La Greca Saint-Esteven Agustina A   Wallimann Philipp P   Günther Manuel M   Konukoglu Ender E   Andratschke Nicolaus N   Guckenberger Matthias M   Tanadini-Lang Stephanie S  

Physics and imaging in radiation oncology 20230626


<h4>Background and purpose</h4>The superior tissue contrast of magnetic resonance (MR) compared to computed tomography (CT) led to an increasing interest towards MR-only radiotherapy. For the latter, the dose calculation should be performed on a synthetic CT (sCT). Patient-specific quality assurance (PSQA) methods have not been established yet and this study aimed to assess several software-based solutions.<h4>Materials and methods</h4>A retrospective study was performed on 20 patients treated a  ...[more]

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