Choi Jae Hyuk, Lee Danny, O'Connor Laura, Chalup Stephan, Welsh James S, Dowling Jason, Greer Peter B
School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia.
Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, NSW, Australia.
Front Oncol. 2019 Oct 2;9:997. doi: 10.3389/fonc.2019.00997. eCollection 2019.
Prostate cancer treatment planning can be performed using magnetic resonance imaging (MRI) only with sCT scans. However, sCT scans are computer generated from MRI data and therefore robust, efficient, and accurate patient-specific quality assurance methods for dosimetric verification are required. Bulk anatomical density (BAD) maps can be generated based on anatomical contours derived from the MRI image. This study investigates and optimizes the BAD map approach for sCT quality assurance with a large patient CT and MRI dataset. 3D T2-weighted MRI and full density CT images of 54 patients were used to create BAD maps with different tissue class combinations. Mean Hounsfield units (HU) of Fat (F: below -30 HU), the entire Tissue [T: excluding bone (B)], and Muscle (M: excluding bone and fat) were derived from the CT scans. CT based BAD maps (BAD and BAD) and a conventional bone and water bulk-density method (BAD) were compared to full CT calculations with bone assignments to 366 HU (measured) and 288 HU (obtained from literature). Optimal bulk densities of Tissue for BAD and Bone for BAD were derived to provide zero mean isocenter dose agreement to the CT plan. Using the optimal densities, the dose agreement of BAD and BAD to CT was redetermined. These maps were then created for the MRI dataset using auto-generated contours and dose calculations compared to CT. The average mean density of Bone, Fat, Muscle, and Tissue were 365.5 ± 62.2, -109.5 ± 12.9, 23.3 ± 9.7, and -46.3 ± 15.2 HU, respectively. Comparing to other bulk-density maps, BAD maps provided the closest dose to CT. Calculated optimal mean densities of Tissue and Bone were -32.7 and 323.7 HU, respectively. The isocenter dose agreement of the optimal density assigned BAD and BAD to full density CT were 0.10 ± 0.65% and 0.01 ± 0.45%, respectively. The isocenter dose agreement of MRI generated BAD and BAD to full density CT were -0.15 ± 0.90% and -0.16 ± 0.65%, respectively. The BAD method with optimal bulk densities can provide robust, accurate and efficient patient-specific quality assurance for dose calculations in MRI-only radiotherapy.
前列腺癌治疗计划仅使用磁共振成像(MRI)和sCT扫描即可完成。然而,sCT扫描是根据MRI数据通过计算机生成的,因此需要强大、高效且准确的针对患者的剂量验证质量保证方法。可以基于从MRI图像得出的解剖轮廓生成体部解剖密度(BAD)图。本研究使用大量患者的CT和MRI数据集对用于sCT质量保证的BAD图方法进行了研究和优化。使用54名患者的3D T2加权MRI和全密度CT图像,通过不同的组织类别组合创建BAD图。脂肪(F:低于-30 HU)、整个组织[T:不包括骨骼(B)]和肌肉(M:不包括骨骼和脂肪)的平均亨氏单位(HU)来自CT扫描。将基于CT的BAD图(BAD和BAD)以及传统的骨和水体密度方法(BAD)与全CT计算进行比较,其中骨骼的赋值分别为366 HU(测量值)和288 HU(从文献中获得)。得出BAD的组织和BAD的骨骼的最佳体密度,以使等中心剂量与CT计划的平均剂量一致为零。使用最佳密度,重新确定BAD和BAD与CT的剂量一致性。然后使用自动生成的轮廓为MRI数据集创建这些图,并将剂量计算结果与CT进行比较。骨骼、脂肪、肌肉和组织的平均密度分别为365.5±62.2、-109.5±12.9、23.3±9.7和-46.3±15.2 HU。与其他体密度图相比,BAD图提供的剂量与CT最接近。计算得出的组织和骨骼的最佳平均密度分别为-32.7和323.7 HU。将最佳密度赋值的BAD和BAD与全密度CT的等中心剂量一致性分别为0.10±0.65%和0.01±0.45%。MRI生成的BAD和BAD与全密度CT的等中心剂量一致性分别为-0.15±0.90%和-0.