Highlights
- •2DcineMRI estimates tumour motion in carbon ion therapy of abdominal site.
- •The estimated motion from cineMRI and 4DCT are significant different.
- •Tumor margins built on cineMRI were compared to the clinical margin.
- •The clinical margin was not significant different from the cineMRI one for gating.
- •Gating treatment is robust to inter-fraction and intra-fraction motion.
Abstract
Purpose
In image-guided particle radiotherapy of abdominal lesions, respiratory motion hinders
treatment accuracy. In this study, 2D cineMRI data were used to quantify the tumor
(GTV) motion and to evaluate the clinical approach based on deriving an internal target
volume (ITV) from a planning 4DCT for gating treatments.
Methods
Seven patients with abdominal lesions were treated with carbon-ion therapy at the
National Centre of Oncological Hadron-therapy (Italy). The MR scan was performed on
the same day of the 4DCT acquisition. For four patients, an additional MR was acquired
approximately after 1 week. The cineMRI combined with deformable image registration
algorithm was used to quantify tumor motion. Afterwards, two ITVs were defined considering
(1) all phases (ITVFB) and (2) only phases within the gating window (ITVG), and then compared with the clinical (4DCT-derived) ITVs (ITVCG and ITVCFB).
Results
Tumor residual motion estimated by cineMRI data in the two MRI sessions resulted not
significantly different from 4DCT, although cineMRI accounted for cycle-to-cycle variations.
The ITV normalized for the GTV median values were higher for ITVFB with respect to ITVG, ITVCFB and ITVCG. The Hausdorff distances with respect to the GTV were up to 10.55 mm, 3.13 mm, 5.56 mm
and 2.51 mm, for ITVFB, ITVG, ITVCFB and ITVCG, respectively. According to both metrics, ITVCG and ITVG were not found significantly different.
Conclusions
CineMRI acquisitions allowed to quantify organ motion without delivering additional
dose to the patient and to verify treatment margins in gated carbon-ion therapy of
abdominal lesions.
Keywords
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Article info
Publication history
Published online: May 30, 2020
Accepted:
May 17,
2020
Received in revised form:
April 3,
2020
Received:
September 27,
2019
Identification
Copyright
© 2020 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
