Results of 2023 survey on the use of synthetic computed tomography for magnetic resonance Imaging-only radiotherapy: Current status and future steps.

Artificial intelligence Clinical implementation Deep learning MR-only planning MR-only radiotherapy Survey Synthetic CT

Journal

Physics and imaging in radiation oncology
ISSN: 2405-6316
Titre abrégé: Phys Imaging Radiat Oncol
Pays: Netherlands
ID NLM: 101704276

Informations de publication

Date de publication:
Oct 2024
Historique:
received: 31 05 2024
revised: 11 09 2024
accepted: 16 09 2024
medline: 9 10 2024
pubmed: 9 10 2024
entrez: 9 10 2024
Statut: epublish

Résumé

The emergence of synthetic CT (sCT) in MR-guided radiotherapy (MRgRT) represents a significant advancement, supporting MR-only workflows and online treatment adaptation. However, the lack of consensus guidelines has led to varied practices. This study reports results from a 2023 ESTRO survey aimed at defining current practices in sCT development and use. An survey was distributed to ESTRO members, including 98 questions across four sections on sCT algorithm generation and usage. By June 2023, 100 centers participated. The survey revealed diverse clinical experiences and roles, with primary sCT use in the pelvis (60%), brain (15%), abdomen (11%), thorax (8%), and head-and-neck (6%). sCT was mostly used for conventional fractionation treatments (68%), photon SBRT (40%), and palliative cases (28%), with limited use in proton therapy (4%). Conditional GANs and GANs were the most used neural network architectures, operating mainly on 1.5 T and 3 T MRI images. Less than half used paired images for training, and only 20% performed image selection. Key MR image quality parameters included magnetic field homogeneity and spatial integrity. Half of the respondents lacked a dedicated sCT-QA program, and many did not apply sanitychecks before calculation. Selection strategies included age, weight, and metal artifacts. A strong consensus (95%) emerged for vendor neutral guidelines. The survey highlights the need for expert-based, vendor-neutral guidelines to standardize sCT tools, metrics, and clinical protocols, ensuring effective sCT use in MR-guided radiotherapy.

Sections du résumé

Background and purpose UNASSIGNED
The emergence of synthetic CT (sCT) in MR-guided radiotherapy (MRgRT) represents a significant advancement, supporting MR-only workflows and online treatment adaptation. However, the lack of consensus guidelines has led to varied practices. This study reports results from a 2023 ESTRO survey aimed at defining current practices in sCT development and use.
Materials and methods UNASSIGNED
An survey was distributed to ESTRO members, including 98 questions across four sections on sCT algorithm generation and usage. By June 2023, 100 centers participated. The survey revealed diverse clinical experiences and roles, with primary sCT use in the pelvis (60%), brain (15%), abdomen (11%), thorax (8%), and head-and-neck (6%). sCT was mostly used for conventional fractionation treatments (68%), photon SBRT (40%), and palliative cases (28%), with limited use in proton therapy (4%).
Results UNASSIGNED
Conditional GANs and GANs were the most used neural network architectures, operating mainly on 1.5 T and 3 T MRI images. Less than half used paired images for training, and only 20% performed image selection. Key MR image quality parameters included magnetic field homogeneity and spatial integrity. Half of the respondents lacked a dedicated sCT-QA program, and many did not apply sanitychecks before calculation. Selection strategies included age, weight, and metal artifacts. A strong consensus (95%) emerged for vendor neutral guidelines.
Conclusion UNASSIGNED
The survey highlights the need for expert-based, vendor-neutral guidelines to standardize sCT tools, metrics, and clinical protocols, ensuring effective sCT use in MR-guided radiotherapy.

Identifiants

pubmed: 39381612
doi: 10.1016/j.phro.2024.100652
pii: S2405-6316(24)00122-2
pmc: PMC11460247
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100652

Informations de copyright

© 2024 The Author(s).

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

M Fusella (M)

Abano Terme Hospital, Department of Radiation Oncology, Abano Terme (Padua), Italy.

E Alvarez Andres (E)

OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.
Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.

F Villegas (F)

Department of Oncology-Pathology, Karolinska Institutet, Solna, Sweden.
Radiotherapy Physics and Engineering, Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Solna, Sweden.

L Milan (L)

Medical Physics Unit, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

T M Janssen (TM)

Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands.

R Dal Bello (R)

University Hospital Zurich and University of Zurich, Department of Radiation Oncology, Zurich, Switzerland.

C Garibaldi (C)

Unit of Radiation Research, IEO, European Institute of Oncology IRCCS, Milan, Italy.

L Placidi (L)

Fondazione Policlinico Universitario Agostino Gemelli, Medical Physics Unit, Roma, Italy.

D Cusumano (D)

Mater Olbia Hospital, Department of Medical Physics, Olbia, (SS), Italy.

Classifications MeSH