Warren D Foltz1, David A Porter2, Anna Simeonov3, Amanda Aleong3, David Jaffray3, Peter Chung3, Kathy Han3, Cynthia Ménard3. 1. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada. Electronic address: warren.foltz@rmp.uhn.on.ca. 2. Fraunhofer Mevis, Bremen, Germany. 3. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Abstract
BACKGROUND AND PURPOSE: Diffusion-weighted imaging using echo-planar imaging (EPI) is prone to geometric inaccuracy, which may limit application to image-guided radiation therapy planning, as well as for voxel-based quantitative multi-parametric or multi-modal approaches. This research investigates pelvic applications at 3 T of a standard single-shot (ssEPI) and a prototype readout-segmented (rsEPI) technique. MATERIALS AND METHODS: Apparent diffusion coefficient (ADC) accuracy and geometric performance of rsEPI and ssEPI were compared using phantoms, and in vivo, involving 8 patients prior to MR-guided brachytherapy for locally advanced cervical cancer, and 19 patients with prostate cancer planned for tumor-targeted radiotherapy. Global and local deviations in geometric performance were tested using Dice Similarity Coefficients (DC) and Hausdorff Distances (HD). RESULTS: In cervix patients, DC increased from 0.76±0.14 to 0.91±0.05 for the high risk clinical target volume, and 0.62±0.26 to 0.85±0.08 for the gross tumor target volume. Tumors in the peripheral zone of the prostate gland were partly projected erroneously outside of the posterior anatomic boundary of the gland by 3.1±1.6 mm in 11 of 19 patients using ADC-ssEPI but not with ADC-rsEPI. CONCLUSIONS: Both cervix and prostate ssEPI are prone to clinically relevant geometric distortions at 3T. rsEPI provides improved geometric performance without post-processing.
BACKGROUND AND PURPOSE: Diffusion-weighted imaging using echo-planar imaging (EPI) is prone to geometric inaccuracy, which may limit application to image-guided radiation therapy planning, as well as for voxel-based quantitative multi-parametric or multi-modal approaches. This research investigates pelvic applications at 3 T of a standard single-shot (ssEPI) and a prototype readout-segmented (rsEPI) technique. MATERIALS AND METHODS: Apparent diffusion coefficient (ADC) accuracy and geometric performance of rsEPI and ssEPI were compared using phantoms, and in vivo, involving 8 patients prior to MR-guided brachytherapy for locally advanced cervical cancer, and 19 patients with prostate cancer planned for tumor-targeted radiotherapy. Global and local deviations in geometric performance were tested using Dice Similarity Coefficients (DC) and Hausdorff Distances (HD). RESULTS: In cervix patients, DC increased from 0.76±0.14 to 0.91±0.05 for the high risk clinical target volume, and 0.62±0.26 to 0.85±0.08 for the gross tumor target volume. Tumors in the peripheral zone of the prostate gland were partly projected erroneously outside of the posterior anatomic boundary of the gland by 3.1±1.6 mm in 11 of 19 patients using ADC-ssEPI but not with ADC-rsEPI. CONCLUSIONS: Both cervix and prostate ssEPI are prone to clinically relevant geometric distortions at 3T. rsEPI provides improved geometric performance without post-processing.
Authors: Lars Bielak; Nicole Wiedenmann; Nils Henrik Nicolay; Thomas Lottner; Johannes Fischer; Hatice Bunea; Anca-Ligia Grosu; Michael Bock Journal: Tomography Date: 2019-09