Journal List > Prog Med Phys > v.24(4) > 1098394

Kim, Shin, Lee, Seo, Lee, Park, Lee, Kim, Kim, Kim, Kay, Jang, and Kang: The Feasibility Study of MRI-based Radiotherapy Treatment Planning Using Look Up Table

Abstract

In the intracranial regions, an accurate delineation of the target volume has been difficult with only the CT data due to poor soft tissue contrast of CT images. Therefore, the magnetic resonance images (MRI) for the delineation of the target volumes were widely used. To calculate dose distributions with MRI-based RTP, the electron density (ED) mapping concept from the diagnostic CT images and the pseudo CT concept from the MRI were introduced. In this study, the look up table (LUT) from the fifteen patients’ diagnostic brain MRI images was created to verify the feasibility of MRI-based RTP. The dose distributions from the MRI-based calculations were compared to the original CT-based calculation. One MRI set has ED information from LUT (lMRI). Another set was generated with voxel values assigned with a homogeneous density of water (wMRI). A simple plan with a single anterior 6MV one portal was applied to the CT, lMRI, and wMRI. Depending on the patient's target geometry for the 3D conformal plan, 6MV photon beams and from two to five gantry portals were used. The differences of the dose distribution and DVH between the lMRI based and CT-based plan were smaller than the wMRI-based plan. The dose difference of wMRI vs. lMRI was measured as 91 cGy vs. 57 cGy at maximum dose, 74 cGt vs. 42 cGy at mean dose, and 94 cGy vs. 53 at minimum dose. The differences of maximum dose, minimum dose, and mean dose of the wMRI-based plan were lower than the lMRI-based plan, because the air cavity was not calculated in the wMRI-based plan. These results prove the feasibility of the lMRI-based planning for brain tumor radiation therapy.

REFERENCES

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Fig. 1.
The OARs are contoured on the magnetic resonance images (MRI) in order to define the gray scales; (a) The brain soft tissue, (b) Eyeball, (c) Nasal cavity, and (d) Bone.
pmp-24-237f1.tif
Fig. 2.
Gray scales of MRI are converted to the CT density via the look up table (LUT).
pmp-24-237f2.tif
Fig. 3.
Dose distributions are shown on the CT image and MR images (a) CT-based isodose curve, (b) lMRI-based isodose curve, and (c) wMRI-based isodose curve.
pmp-24-237f3.tif
Fig. 4.
The CT and MR based radiation therapy plans were compared with the DVH of brainstem.
pmp-24-237f4.tif
Fig. 5.
15 patients average maximum dose difference between wMRI and lMRI based plans. The reference dose were CT-based plans.
pmp-24-237f5.tif
Fig. 6.
15 patients average mean dose difference between wMRI and lMRI based plans. The reference dose were CT-based plans.
pmp-24-237f6.tif
Fig. 7.
15 patients average minimum dose difference between wMRI and lMRI based plans. The reference dose were CT-based plans.
pmp-24-237f7.tif
Table 1.
General patients’ information and patients’ gray scale data at OARs.
Patients Age Gender Diagnosis Brain Eyeball Cavity Bone
1 57 Male Glioblastoma 739 329 98 1,277
2 49 Male Glioblastoma  701 283 21 1,362
3 51 Male Anaplastic astrocytoma  747 306 54 1,261
4 63 Female Anaplastic oligdendroglioma  778 328 15 1,414
5 38 Female Glioblastoma 721 318 17 1,119
6 41 Male Glioblastoma  616 307 9.9 1,217
7 71 Female Anaplastic oligdendroglioma  624 294 65 1,223
8 38 Female Glioblastoma  539 226 16 1,024
9 44 Male Glioblastoma  694 305 19 1,178
10 50 Male Anaplastic oligdendroglioma  719 307 39 1,152
11 51 Female Glioblastoma 645 292 45 1,220
12 74 Female Glioblastoma  637 275 14 1,182
13 81 Female Glioblastoma 533 235 19 1,116
14 35 Male Anaplastic astrocytoma  658 293 9.7 1,348
15 41 Female Anaplastic astrocytoma 652 294 9.6 1,207
Range 35∼81     533∼739 226∼329 9.6∼98 1,024∼1,362
Average 52.3     666.9 292.8 30.1 1,220.0
SD 14.2     71.7 29.4 25.5 102.3

Standard deviation.

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