Accuracy and precision of apparent diffusion coefficient measurements on a 1.5 T MR-Linac in central nervous system tumour patients.
Diffusion-weighted imaging
MR-Linac
MRI guided radiation therapy
Quantitative MRI
Radiation therapy
Treatment monitoring
Journal
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
30
07
2021
revised:
20
09
2021
accepted:
22
09
2021
pubmed:
1
10
2021
medline:
31
12
2021
entrez:
30
9
2021
Statut:
ppublish
Résumé
MRI linear accelerators (MR-Linacs) may allow treatment adaptation to be guided by quantitative MRI including diffusion-weighted imaging (DWI). The aim of this study was to evaluate the accuracy and precision of apparent diffusion coefficient (ADC) measurements from DWI on a 1.5 T MR-Linac in patients with central nervous system (CNS) tumours through comparison with a diagnostic scanner. CNS patients were treated using a 1.5 T Elekta Unity MR-Linac. DWI was acquired during MR-Linac treatment and on a Philips Ingenia 1.5 T. The agreement between the two scanners on median ADC over the gross tumour/clinical target volumes (GTV/CTV) and in brain regions (white/grey matter, cerebrospinal fluid (CSF)) was computed. Repeated scans were used to estimate ADC repeatability. Daily changes in ADC over the GTV of high-grade gliomas were characterized from MR-Linac scans. DWI from 59 patients was analyzed. MR-Linac ADC measurements showed a small bias relative to Ingenia measurements in white matter, grey matter, GTV, and CTV (bias: -0.05 ± 0.03, -0.08 ± 0.05, -0.1 ± 0.1, -0.08 ± 0.07 μm It is possible to obtain ADC measurements in the brain on a 1.5 T MR-Linac that are comparable to those of diagnostic-quality scanners. This technical validation study adds to the foundation for future studies that will correlate brain tumour ADC with clinical outcomes.
Sections du résumé
BACKGROUND AND PURPOSE
MRI linear accelerators (MR-Linacs) may allow treatment adaptation to be guided by quantitative MRI including diffusion-weighted imaging (DWI). The aim of this study was to evaluate the accuracy and precision of apparent diffusion coefficient (ADC) measurements from DWI on a 1.5 T MR-Linac in patients with central nervous system (CNS) tumours through comparison with a diagnostic scanner.
MATERIALS AND METHODS
CNS patients were treated using a 1.5 T Elekta Unity MR-Linac. DWI was acquired during MR-Linac treatment and on a Philips Ingenia 1.5 T. The agreement between the two scanners on median ADC over the gross tumour/clinical target volumes (GTV/CTV) and in brain regions (white/grey matter, cerebrospinal fluid (CSF)) was computed. Repeated scans were used to estimate ADC repeatability. Daily changes in ADC over the GTV of high-grade gliomas were characterized from MR-Linac scans.
RESULTS
DWI from 59 patients was analyzed. MR-Linac ADC measurements showed a small bias relative to Ingenia measurements in white matter, grey matter, GTV, and CTV (bias: -0.05 ± 0.03, -0.08 ± 0.05, -0.1 ± 0.1, -0.08 ± 0.07 μm
CONCLUSIONS
It is possible to obtain ADC measurements in the brain on a 1.5 T MR-Linac that are comparable to those of diagnostic-quality scanners. This technical validation study adds to the foundation for future studies that will correlate brain tumour ADC with clinical outcomes.
Identifiants
pubmed: 34592363
pii: S0167-8140(21)06743-8
doi: 10.1016/j.radonc.2021.09.020
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
155-162Subventions
Organisme : CIHR
ID : CIHR 156252
Pays : Canada
Organisme : CIHR
ID : CIHR 148660
Pays : Canada
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest Dr. Arjun Sahgal: Advisor/consultant with Abbvie, Merck, Roche, Varian (Medical Advisory Group), Elekta (Gamma Knife Icon), BrainLAB, and VieCure (Medical Advisory Board); Past educational seminars with Elekta AB, Accuray Inc., Varian (CNS Teaching Faculty), BrainLAB, Medtronic Kyphon; Research grant with Elekta AB; Travel accommodations/expenses by Elekta, Varian, BrainLAB. Dr. Chia-Lin Tseng: Travel accommodations/expenses & honoraria for past educational seminars by Elekta; belongs to the Elekta MR-Linac Research Consortium; advisor/consultant with Sanofi. Dr. Sten Myrehaug: Received research support from Novartis AG, honoraria from Novartis AG and Ipsen and travel support from Elekta. None related to this work. Dr. Mark Ruschin: Co‐inventor of and owns associated intellectual property specific to the image‐guidance system on the Gamma Knife Icon. None related to this work. Mrs. Mikki Campbell: Received honorarium for past educational seminars with Elekta AB; received research grants with Elekta AB; and travel accommodations/expenses by Elekta; belongs to the Elekta MR Linac Research Consortium. Dr. Brige Chugh: Previously held an industry partnership grant with Modus QA.