Clinical validation of MR imaging time reduction for substitute/synthetic CT generation for prostate MRI-only treatment planning.

Radiotherapy treatment planning based only on magnetic resonance imaging (MRI) has become clinically achievable. Though computed tomography (CT) is the gold standard for radiotherapy imaging, directly providing the electron density values needed for planning calculations, MRI has superior soft tissue visualisation to guide treatment planning decisions and optimisation. MRI-only planning removes the need for the CT scan, but requires generation of a substitute/synthetic/pseudo CT (sCT) for electron density information.

Repeatability and reproducibility of magnetic resonance imaging-based radiomic features in rectal cancer.

Radiomics of magnetic resonance images (MRIs) in rectal cancer can non-invasively characterize tumor heterogeneity with potential to discover new imaging biomarkers. However, for radiomics to be reliable, the imaging features measured must be stable and reproducible. The aim of this study is to quantify the repeatability and reproducibility of MRI-based radiomic features in rectal cancer.

Dynamic Contrast-enhanced Magnetic Resonance Imaging Evaluation of Whole Tumour Perfusion Heterogeneity Predicts Distant Disease-free Survival in Locally Advanced Rectal Cancer.

Aims: To evaluate diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging for the prediction of disease-free survival (DFS) in patients with locally advanced rectal cancer.

Materials And Methods: Patients with stage II or III rectal adenocarcinoma undergoing neoadjuvant chemoradiotherapy (CRT) and surgery were eligible. Patients underwent multi-parametric magnetic resonance imaging (diffusion-weighted imaging and dynamic contrast-enhanced) before CRT, during CRT (week 3) and after CRT (1 week prior to surgery).

Rates of MRI simulator utilisation in a tertiary cancer therapy centre.

Magnetic resonance imaging (MRI) is increasingly being integrated into the radiation oncology workflow, due to its improved soft tissue contrast without additional exposure to ionising radiation. A review of MRI utilisation according to evidence based departmental guidelines was performed. Guideline utilisation rates were calculated to be 50% (true utilisation rate was 46%) of all new cancer patients treated with adjuvant or curative intent, excluding simple skin and breast cancer patients.

Integrated MRI-guided radiotherapy - opportunities and challenges.

MRI can help to categorize tissues as malignant or non-malignant both anatomically and functionally, with a high level of spatial and temporal resolution. This non-invasive imaging modality has been integrated with radiotherapy in devices that can differentially target the most aggressive and resistant regions of tumours. The past decade has seen the clinical deployment of treatment devices that combine imaging with targeted irradiation, making the aspiration of integrated MRI-guided radiotherapy (MRIgRT) a reality.

Experimental characterisation of the magnetic field correction factor,kB⃗,for Roos chambers in a parallel MRI-linac.

Reference dosimetry on an MRI-linac requires a chamber specific magnetic field correction factor,kB⃗.This work aims to measure the correction factor for a parallel plate chamber on a parallel MRI-linac.kB⃗is defined as the ratio of the absorbed dose to water calibration coefficient in the presence of the magnetic field,ND,wB⃗relative to that under 0 T conditions,ND,w0T.

Characterizing magnetically focused contamination electrons by off-axis irradiation on an inline MRI-Linac.

Purpose: The aim of this study is to investigate off-axis irradiation on the Australian MRI-Linac using experiments and Monte Carlo simulations. Simulations are used to verify experimental measurements and to determine the minimum offset distance required to separate electron contamination from the photon field.

Methods: Dosimetric measurements were performed using a microDiamond detector, Gafchromic EBT3 film, and MOSkin .

Multi-parametric magnetic resonance imaging assessment of whole tumour heterogeneity for chemoradiotherapy response prediction in rectal cancer.

Background And Purpose: Prediction of chemoradiotherapy response (CRT) in locally advanced rectal cancer would enable stratification of management. The purpose was to prospectively evaluate multi-parametric magnetic resonance imaging (MRI) assessment of tumour heterogeneity combining diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI for the prediction of CRT response in locally advanced rectal cancer.

Materials And Methods: Patients with Stage II or III rectal adenocarcinoma undergoing neoadjuvant CRT and surgery underwent MRI (DWI and DCE) before, during (week 3), and after CRT (1 week before surgery).

Effects of MR imaging time reduction on substitute CT generation for prostate MRI-only treatment planning.

The introduction of MRI linear accelerators (MR-linacs) and the increased use of MR imaging in radiotherapy, requires improved approaches to MRI-only radiotherapy. MRI provides excellent soft tissue visualisation but does not provide any electron density information required for radiotherapy dose calculation, instead MRI is registered to CT images to enable dose calculations. MRI-only radiotherapy eliminates registration errors and reduces patient discomfort, workload and cost.

IPEM Topical Report: an international IPEM survey of MRI use for external beam radiotherapy treatment planning.

. Despite growing interest in magnetic resonance imaging (MRI), integration in external beam radiotherapy (EBRT) treatment planning uptake varies globally. In order to understand the current international landscape of MRI in EBRT a survey has been performed in 11 countries.

Imaging performance of a high-field in-line magnetic resonance imaging linear accelerator with a patient rotation system for fixed-gantry radiotherapy.

This paper describes the imaging performance of a high-field in-line MRI linear accelerator with a patient rotation system in-situ. Signal quality was quantified using signal-to-noise ratio (SNR) and RF uniformity maps. B0-field inhomogeneity was assessed using magnetic field mapping.

IPEM topical report: guidance on the use of MRI for external beam radiotherapy treatment planning.

This document gives guidance for multidisciplinary teams within institutions setting up and using an MRI-guided radiotherapy (RT) treatment planning service. It has been written by a multidisciplinary working group from the Institute of Physics and Engineering in Medicine (IPEM). Guidance has come from the experience of the institutions represented in the IPEM working group, in consultation with other institutions, and where appropriate references are given for any relevant legislation, other guidance documentation and information in the literature.

Quantitative MRI: Defining repeatability, reproducibility and accuracy for prostate cancer imaging biomarker development.

Introduction: Quantitative MRI (qMRI) parameters have been increasingly used to develop predictive models to accurately monitor treatment response in prostate cancer after radiotherapy. To reliably detect changes in signal due to treatment response, predictive models require qMRI parameters with high repeatability and reproducibility. The purpose of this study was to measure qMRI parameter uncertainties in both commercial and in-house developed phantoms to guide the development of robust predictive models for monitoring treatment response.

Measurements of human tolerance to horizontal rotation within an MRI scanner: Towards gantry-free radiation therapy.

Introduction: Recent advances in image guidance and adaptive radiotherapy could enable gantry-free radiotherapy using patient rotation. Gantry-free radiotherapy could substantially reduce the cost of radiotherapy systems and facilities. MRI guidance complements a gantry-free approach because of its ability to visualise soft tissue deformation during rotation.

Pelvic organ motion and dosimetric implications during horizontal patient rotation for prostate radiation therapy.

Purpose: Gantry-free radiation therapy systems utilizing patient rotation would be simpler and more cost effective than the conventional gantry-based systems. Such a system could enable the expansion of radiation therapy to meet global demand and reduce capital costs. Recent advances in adaptive radiation therapy could potentially be applied to correct for gravitational deformation during horizontal patient rotation.

First experimental investigation of simultaneously tracking two independently moving targets on an MRI-linac using real-time MRI and MLC tracking.

Purpose: High quality radiotherapy is challenging in cases where multiple targets with independent motion are simultaneously treated. A real-time tumor tracking system that can simultaneously account for the motion of two targets was developed and characterized.

Methods: The multitarget tracking system was implemented on a magnetic resonance imaging (MRI)-linac and utilized multi-leaf collimator (MLC) tracking to adapt the radiation beam to phantom targets reproducing motion with prostate and lung motion traces.

Tissue mimicking materials for imaging and therapy phantoms: a review.

Tissue mimicking materials (TMMs), typically contained within phantoms, have been used for many decades in both imaging and therapeutic applications. This review investigates the specifications that are typically being used in development of the latest TMMs. The imaging modalities that have been investigated focus around CT, mammography, SPECT, PET, MRI and ultrasound.

Towards real-time 4D radiation dosimetry on an MRI-Linac.

4D radiation dosimetry using a highly radiation-sensitive polymer gel dosimeter with real-time quantitative magnetic resonance imaging (MRI) readout is presented as a technique to acquire the accumulated radiation dose distribution during image-guided radiotherapy on an MRI-Linac. Optimized T -weighted Turbo-Spin-Echo (TSE) scans are converted into quantitative ΔR maps and subsequently to radiation dose maps. The concept of temporal uncertainty is introduced as a metric of effective temporal resolution.

Multicenter evaluation of MRI-based radiomic features: A phantom study.

Introduction: This work describes the development of a novel radiomics phantom designed for magnetic resonance imaging (MRI) that can be used in a multicenter setting. The purpose of this study is to assess the stability and reproducibility of MRI-based radiomic features using this phantom across different MRI scanners.

Methods & Materials: A set of phantoms were three-dimensional (3D) printed using MRI visible materials.

Dosimetric Optimization and Commissioning of a High Field Inline MRI-Linac.

Unique characteristics of MRI-linac systems and mutual interactions between their components pose specific challenges for their commissioning and quality assurance. The Australian MRI-linac is a prototype system which explores the inline orientation, with radiation beam parallel to the main magnetic field. The aim of this work was to commission the radiation-related aspects of this system for its application in clinical treatments.

High resolution silicon array detector implementation in an inline MRI-linac.

Purpose: Dynamic dosimaging is a concept whereby a detector in motion is tracked with magnetic resonance imaging (MRI) to validate the amount and position of dose in a radiation therapy treatment on an MRI-linac. This work takes steps toward the realization of dynamic dosimaging with the novel high resolution silicon array detector: MagicPlate-512 (M512). The performance of the M512 was assessed in a 1.

Geometric distortion characterization and correction for the 1.0 T Australian MRI-linac system using an inverse electromagnetic method.

Purpose: The magnetic resonance imaging (MRI)-Linac system combines a MRI scanner and a linear accelerator (Linac) to realize real-time localization and adaptive radiotherapy for tumors. Given that the Australian MRI-Linac system has a 30-cm diameter of spherical volume (DSV) with a shimmed homogeneity of ±4.05 parts per million (ppm), a gradient nonlinearity (GNL) of <5% can only be assured within 15 cm from the system's isocenter.

A Multi-center Prospective Study for Implementation of an MRI-Only Prostate Treatment Planning Workflow.

This project investigates the feasibility of implementation of MRI-only prostate planning in a prospective multi-center study. A two-phase implementation model was utilized where centers performed retrospective analysis of MRI-only plans for five patients followed by prospective MRI-only planning for subsequent patients. Feasibility was assessed if at least 23/25 patients recruited to phase 2 received MRI-only treatment workflow.