Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation Review
| Authors: | McDonald, B. A.; Zachiu, C.; Christodouleas, J.; Naser, M. A.; Ruschin, M.; Sonke, J. J.; Thorwarth, D.; Létourneau, D.; Tyagi, N.; Tadic, T.; Yang, J.; Li, X. A.; Bernchou, U.; Hyer, D. E.; Snyder, J. E.; Bubula-Rehm, E.; Fuller, C. D.; Brock, K. K. |
| Review Title: | Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation |
| Abstract: | MRI-linear accelerator (MR-linac) devices have been introduced into clinical practice in recent years and have enabled MR-guided adaptive radiation therapy (MRgART). However, by accounting for anatomical changes throughout radiation therapy (RT) and delivering different treatment plans at each fraction, adaptive radiation therapy (ART) highlights several challenges in terms of calculating the total delivered dose. Dose accumulation strategies—which typically involve deformable image registration between planning images, deformable dose mapping, and voxel-wise dose summation—can be employed for ART to estimate the delivered dose. In MRgART, plan adaptation on MRI instead of CT necessitates additional considerations in the dose accumulation process because MRI pixel values do not contain the quantitative information used for dose calculation. In this review, we discuss considerations for dose accumulation specific to MRgART and in relation to current MR-linac clinical workflows. We present a general dose accumulation framework for MRgART and discuss relevant quality assurance criteria. Finally, we highlight the clinical importance of dose accumulation in the ART era as well as the possible ways in which dose accumulation can transform clinical practice and improve our ability to deliver personalized RT. Copyright © 2023 McDonald, Zachiu, Christodouleas, Naser, Ruschin, Sonke, Thorwarth, Létourneau, Tyagi, Tadic, Yang, Li, Bernchou, Hyer, Snyder, Bubula-Rehm, Fuller and Brock. |
| Keywords: | review; validation process; nuclear magnetic resonance imaging; clinical practice; quality control; computer assisted tomography; drug accumulation; algorithm; dosimetry; quantitative analysis; image registration; electron; clinical target volume; image segmentation; image guided radiotherapy; biomechanics; adaptive radiation; adaptive radiation therapy; deformable image registration; clinical significance; human; dose accumulation; autosegmentation; mr-guided radiation therapy; mr-linac; target registration error; deformable dose mapping; dose summation; electron density mapping; mr guided adaptive radiation therapy; tissue biomechanics |
| Journal Title: | Frontiers in Oncology |
| Volume: | 12 |
| ISSN: | 2234-943X |
| Publisher: | Frontiers Media S.A. |
| Date Published: | 2022-01-01 |
| Start Page: | 1086258 |
| Language: | English |
| DOI: | 10.3389/fonc.2022.1086258 |
| PROVIDER: | scopus |
| PMCID: | PMC9909539 |
| PUBMED: | 36776378 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 March 2023 -- Source: Scopus |
