De Pietro Simona, Di Martino Giulia, Caroprese Mara, Barillaro Angela, Cocozza Sirio, Pacelli Roberto, Cuocolo Renato, Ugga Lorenzo, Briganti Francesco, Brunetti Arturo, Conson Manuel, Elefante Andrea
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.
Insights Imaging. 2024 Oct 23;15(1):255. doi: 10.1186/s13244-024-01799-1.
Over the last few years, radiation therapy (RT) techniques have evolved very rapidly, with the aim of conforming high-dose volume tightly to a target. Although to date CT is still considered the imaging modality for target delineation, it has some known limited capabilities in properly identifying pathologic processes occurring, for instance, in soft tissues. This limitation, along with other advantages such as dose reduction, can be overcome using magnetic resonance imaging (MRI), which is increasingly being recognized as a useful tool in RT clinical practice. This review has a two-fold aim of providing a basic introduction to the physics of MRI in a narrative way and illustrating the current knowledge on its application "from head to toe" (i.e., different body sites), in order to highlight the numerous advantages in using MRI to ensure the best therapeutic response. We provided a basic introduction for residents and non-radiologist on the physics of MR and reported evidence of the advantages and future improvements of MRI in planning a tailored radiotherapy treatment "from head to toe". CRITICAL RELEVANCE STATEMENT: This review aims to help understand how MRI has become indispensable, not only to better characterize and evaluate lesions, but also to predict the evolution of the disease and, consequently, to ensure the best therapeutic response. KEY POINTS: MRI is increasingly gaining interest and applications in RT planning. MRI provides high soft tissue contrast resolution and accurate delineation of the target volume. MRI will increasingly become indispensable for characterizing and evaluating lesions, and to predict the evolution of disease.
在过去几年中，放射治疗（RT）技术发展迅速，目的是使高剂量体积紧密贴合靶区。尽管迄今为止CT仍被视为用于靶区勾画的成像方式，但它在准确识别例如软组织中发生的病理过程方面存在一些已知的局限性。利用磁共振成像（MRI）可以克服这一局限性以及其他优势，如剂量降低，MRI在RT临床实践中越来越被视为一种有用的工具。本综述有两个目的：一是以叙述的方式对MRI的物理原理进行基本介绍，二是阐述目前关于其“从头到脚”（即不同身体部位）应用的知识，以突出使用MRI确保最佳治疗反应的诸多优势。我们为住院医师和非放射科医生提供了关于MR物理原理的基本介绍，并报告了MRI在“从头到脚”规划定制放射治疗中的优势及未来改进的证据。关键相关性声明：本综述旨在帮助理解MRI如何变得不可或缺，不仅能更好地表征和评估病变，还能预测疾病的发展，从而确保最佳治疗反应。要点：MRI在RT规划中越来越受到关注并得到应用。MRI提供高软组织对比分辨率和准确的靶区体积勾画。MRI在表征和评估病变以及预测疾病发展方面将越来越不可或缺。
