Kamal Singhrao1, Jie Fu1, Holden H Wu2, Peng Hu2, Amar U Kishan1, Robert K Chin1, John H Lewis3. 1. Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, 90095, USA. 2. Department of Radiology, University of California Los Angeles, Los Angeles, CA, 90095, USA. 3. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Abstract
PURPOSE: Increased utilization of magnetic resonance imaging (MRI) in radiotherapy has caused a growing need for phantoms that provide tissue-like contrast in both computed tomography (CT) and MRI images. Such phantoms can be used to compare MRI-based processes with CT-based clinical standards. Here, we develop and demonstrate the clinical utility of a three-dimensional (3D)-printed anthropomorphic pelvis phantom containing materials capable of T1 , T2 , and electron density matching for a clinically relevant set of soft tissues and bone. METHODS: The phantom design was based on a male pelvic anatomy template with thin boundaries separating tissue types. Slots were included to allow insertion of various dosimeters. The phantom structure was created using a 3D printer. The tissue compartments were filled with carrageenan-based materials designed to match the T1 and T2 relaxation times and electron densities of the corresponding tissues. CT and MRI images of the phantom were acquired and used to compare phantom T1 and T2 relaxation times and electron densities to literature-reported values for human tissue. To demonstrate clinical utility, the phantom was used for end-to-end testing of an MRI-only treatment simulation and planning workflow. Based on a T2 -weighted MRI image, synthetic CT (sCT) images were created using a statistical decomposition algorithm (MRIPlanner, Spectronic Research AB, Sweden) and used for dose calculation of volumetric-modulated arc therapy (VMAT) and seven-field intensity-modulated radiation therapy (IMRT) prostate plans. The plans were delivered on a Truebeam STX (Varian Medical Systems, Palo Alto, CA), with film and a 0.3 cc ion chamber used to measure the delivered dose. Doses calculated on the CT and sCTs were compared using common dose volume histogram metrics. RESULTS: T1 and T2 relaxation time and electron density measurements for the muscle, prostate, and bone agreed well with literature-reported in vivo measurements. Film analysis resulted in a 99.7% gamma pass rate (3.0%, 3.0 mm) for both plans. The ion chamber-measured dose discrepancies at the isocenter were 0.36% and 1.67% for the IMRT and VMAT plans, respectively. The differences in PTV D98% and D95% between plans calculated on the CT and 1.5T/3.0 T-derived sCT images were under 3%. CONCLUSION: The developed phantom provides tissue-like contrast on MRI and CT and can be used to validate MRI-based processes through comparison with standard CT-based processes.
PURPOSE: Increased utilization of magnetic resonance imaging (MRI) in radiotherapy has caused a growing need for phantoms that provide tissue-like contrast in both computed tomography (CT) and MRI images. Such phantoms can be used to compare MRI-based processes with CT-based clinical standards. Here, we develop and demonstrate the clinical utility of a three-dimensional (3D)-printed anthropomorphic pelvis phantom containing materials capable of T1 , T2 , and electron density matching for a clinically relevant set of soft tissues and bone. METHODS: The phantom design was based on a male pelvic anatomy template with thin boundaries separating tissue types. Slots were included to allow insertion of various dosimeters. The phantom structure was created using a 3D printer. The tissue compartments were filled with carrageenan-based materials designed to match the T1 and T2 relaxation times and electron densities of the corresponding tissues. CT and MRI images of the phantom were acquired and used to compare phantom T1 and T2 relaxation times and electron densities to literature-reported values for human tissue. To demonstrate clinical utility, the phantom was used for end-to-end testing of an MRI-only treatment simulation and planning workflow. Based on a T2 -weighted MRI image, synthetic CT (sCT) images were created using a statistical decomposition algorithm (MRIPlanner, Spectronic Research AB, Sweden) and used for dose calculation of volumetric-modulated arc therapy (VMAT) and seven-field intensity-modulated radiation therapy (IMRT) prostate plans. The plans were delivered on a Truebeam STX (Varian Medical Systems, Palo Alto, CA), with film and a 0.3 cc ion chamber used to measure the delivered dose. Doses calculated on the CT and sCTs were compared using common dose volume histogram metrics. RESULTS: T1 and T2 relaxation time and electron density measurements for the muscle, prostate, and bone agreed well with literature-reported in vivo measurements. Film analysis resulted in a 99.7% gamma pass rate (3.0%, 3.0 mm) for both plans. The ion chamber-measured dose discrepancies at the isocenter were 0.36% and 1.67% for the IMRT and VMAT plans, respectively. The differences in PTV D98% and D95% between plans calculated on the CT and 1.5T/3.0 T-derived sCT images were under 3%. CONCLUSION: The developed phantom provides tissue-like contrast on MRI and CT and can be used to validate MRI-based processes through comparison with standard CT-based processes.