D M de Muinck Keizer1, L G W Kerkmeijer2, T Willigenburg3, A L H M W van Lier4, M D den Hartogh5, J R N van der Voort van Zyp6, E N de Groot-van Breugel7, B W Raaymakers8, J J W Lagendijk9, J C J de Boer10. 1. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: D.M.deMuinckKeizer@umcutrecht.nl. 2. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: L.Kerkmeijer@umcutrecht.nl. 3. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: T.Willigenburg-3@umcutrecht.nl. 4. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: A.L.H.M.W.vanLier@umcutrecht.nl. 5. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: M.denHartogh-3@umcutrecht.nl. 6. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: J.R.N.vanderVoortvanZyp@umcutrecht.nl. 7. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: E.vanBreugel@umcutrecht.nl. 8. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: B.W.Raaymakers@umcutrecht.nl. 9. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: J.J.W.Lagendijk@umcutrecht.nl. 10. Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: J.C.J.deBoer-6@umcutrecht.nl.
Abstract
PURPOSE: To evaluate prostate intrafraction motion using MRI during the full course of online adaptive MR-Linac radiotherapy (RT) fractions, in preparation of MR-guided extremely hypofractionated RT. MATERIAL AND METHODS: Five low and intermediate risk prostate cancer patients were treated with 20 × 3.1 Gy fractions on a 1.5T MR-Linac. Each fraction, initial MRI (Pre) scans were obtained at the start of every treatment session. Pre-treatment planning MRI contours were propagated and adapted to this Pre scan after which plan re-optimization was started in the treatment planning system followed by dose delivery. 3D Cine-MR imaging was started simultaneously with beam-on and acquired over the full beam-on period. Prostate intrafraction motion in this cine-MR was determined with a previously validated soft-tissue contrast based tracking algorithm. In addition, absolute accuracy of the method was determined using a 4D phantom. RESULTS: Prostate motion was completely automatically determined over the full on-couch period (approx. 45 min) with no identified mis-registrations. The translation 95% confidence intervals are within clinically applied margins of 5 mm, and plan adaption for intrafraction motion was required in only 4 out of 100 fractions. CONCLUSION: This is the first study to investigate prostate intrafraction motions during entire MR-guided RT sessions on an MR-Linac. We have shown that high quality 3D cine-MR imaging and prostate tracking during RT is feasible with beam-on. The clinically applied margins of 5 mm have proven to be sufficient for these treatments and may potentially be further reduced using intrafraction plan adaptation guided by cine-MR imaging.
PURPOSE: To evaluate prostate intrafraction motion using MRI during the full course of online adaptive MR-Linac radiotherapy (RT) fractions, in preparation of MR-guided extremely hypofractionated RT. MATERIAL AND METHODS: Five low and intermediate risk prostate cancerpatients were treated with 20 × 3.1 Gy fractions on a 1.5T MR-Linac. Each fraction, initial MRI (Pre) scans were obtained at the start of every treatment session. Pre-treatment planning MRI contours were propagated and adapted to this Pre scan after which plan re-optimization was started in the treatment planning system followed by dose delivery. 3D Cine-MR imaging was started simultaneously with beam-on and acquired over the full beam-on period. Prostate intrafraction motion in this cine-MR was determined with a previously validated soft-tissue contrast based tracking algorithm. In addition, absolute accuracy of the method was determined using a 4D phantom. RESULTS: Prostate motion was completely automatically determined over the full on-couch period (approx. 45 min) with no identified mis-registrations. The translation 95% confidence intervals are within clinically applied margins of 5 mm, and plan adaption for intrafraction motion was required in only 4 out of 100 fractions. CONCLUSION: This is the first study to investigate prostate intrafraction motions during entire MR-guided RT sessions on an MR-Linac. We have shown that high quality 3D cine-MR imaging and prostate tracking during RT is feasible with beam-on. The clinically applied margins of 5 mm have proven to be sufficient for these treatments and may potentially be further reduced using intrafraction plan adaptation guided by cine-MR imaging.
Authors: Amit Roy; Olga Green; Randall Brenneman; Walter Bosch; Hiram A Gay; Jeff M Michalski; Brian C Baumann Journal: Clin Genitourin Cancer Date: 2022-01-11 Impact factor: 3.121
Authors: Thomas Willigenburg; Ellis Beld; Jochem Hes; Jan J W Lagendijk; Hans C J de Boer; Marinus A Moerland; Jochem R N van der Voort van Zyp Journal: Phys Imaging Radiat Oncol Date: 2020-08-07
Authors: Thomas Willigenburg; Daan M de Muinck Keizer; Max Peters; An Claes; Jan J W Lagendijk; Hans C J de Boer; Jochem R N van der Voort van Zyp Journal: Clin Transl Radiat Oncol Date: 2021-01-14
Authors: Daan M de Muinck Keizer; Jochem R N van der Voort van Zyp; Eline N de Groot-van Breugel; Bas W Raaymakers; Jan J W Lagendijk; Hans C J de Boer Journal: Phys Imaging Radiat Oncol Date: 2021-07-25
Authors: Duncan den Boer; Mariska D den Hartogh; Alexis N T J Kotte; Jochem R N van der Voort van Zyp; Juus L Noteboom; Gijsbert H Bol; Thomas Willigenburg; Anita M Werensteijn-Honingh; Ina M Jürgenliemk-Schulz; Astrid L H M W van Lier; Petra S Kroon Journal: Phys Imaging Radiat Oncol Date: 2021-11-20
Authors: Enrica Seravalli; Petra S Kroon; John M Buatti; Matthew D Hall; Henry C Mandeville; Karen J Marcus; Cem Onal; Enis Ozyar; Arnold C Paulino; Frank Paulsen; Daniel Saunders; Derek S Tsang; Suzanne L Wolden; Geert O Janssens Journal: Clin Transl Radiat Oncol Date: 2021-06-04
Authors: Daniel Wegener; Daniel Zips; Cihan Gani; Simon Boeke; Konstantin Nikolaou; Ahmed E Othman; Haidara Almansour; Frank Paulsen; Arndt-Christian Müller Journal: Radiologe Date: 2021-07-23 Impact factor: 0.635