AI Article Synopsis

  • - The study investigated how different respiratory motion management techniques, specifically abdominal compression (AC) and breath hold (BH), affect the identification of critical abdominal organs at risk (OAR) in MRI images used for radiotherapy.
  • - Four observers evaluated scans with different motion management methods, measuring how consistently they could delineate the stomach, liver, and duodenum, while also assessing visibility.
  • - Results showed no single method had clear advantages in delineation accuracy, highlighting the importance of tailoring motion management strategies to individual patient circumstances.

Article Abstract

Background And Purpose: The impact of respiratory motion management strategies for abdominal radiotherapy, such as abdominal compression (AC) and breath hold (BH), on abdominal organ at risk (OAR) delineation on magnetic resonance imaging (MRI) is unknown. This feasibility study compared the inter- and intra- observer delineation variation on MRI acquired with AC, BH for three critical abdominal OAR.

Materials And Methods: T2-weighted (W) 3D MRI in free-breathing (FB) and with AC, and T1W 3D mDixon exhale BH were acquired. Four observers blinded to motion management strategy used, delineated stomach, liver, and duodenum on all MRI. One case per strategy was repeated over 6 weeks later to quantify intra-observer variation. Simultaneous truth and performance level estimation (STAPLE) contours for each OAR were generated, median and IQR mean distance to agreement (mDTA) and maximum Hausdorff distance (HD) between observer and STAPLE contours were calculated. Observers scored organ visibility on each MRI using a four-point Likert scale.

Results: A total of 27 scans including repeats were delineated. Pooled mDTA for all OARs was 1.3 mm (0.5 mm) with AC, 1.4 mm (1.0 mm) with BH, and 1.3 mm (0.5 mm) in FB. Intra-observer mDTA was highest for all organs in FB with 10.8 mm for duodenum, 1.8 mm for liver, and 2.7 mm for stomach. The pooled mean perceptual quality score value was highest for AC across organs.

Conclusions: No motion management strategy demonstrated superior similarity across OAR, emphasizing the need for personalised approaches based on individual clinical and patient factors.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459006PMC
http://dx.doi.org/10.1016/j.phro.2024.100650DOI Listing

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