Feasibility of quantitative relaxometry for prostate target localization and response assessment in magnetic resonance-guided online adaptive stereotactic body radiotherapy Journal Article
| Authors: | Subashi, E.; LoCastro, E.; Burleson, S.; Apte, A.; Zelefsky, M.; Tyagi, N. |
| Article Title: | Feasibility of quantitative relaxometry for prostate target localization and response assessment in magnetic resonance-guided online adaptive stereotactic body radiotherapy |
| Abstract: | Purpose: Multiparametric magnetic resonance imaging (MRI) is known to provide predictors for malignancy and treatment outcome. The inclusion of these datasets in workflows for online adaptive planning remains under investigation. We demonstrate the feasibility of longitudinal relaxometry in online MR-guided adaptive stereotactic body radiotherapy (SBRT) to the prostate and dominant intra-prostatic lesion (DIL). Methods: Fifty patients with intermediate-risk prostate cancer were included in the study. The clinical target volume (CTV) was defined as the prostate gland plus 1 cm of seminal vesicles. The gross tumor volume (GTV) was defined as the DIL identified on multiparametric MRI. Online adaptive radiotherapy was delivered in a 1.5 T MR-Linac using a prescription of 800 cGy/900 cGy × 5 fractions to the CTV + 3 mm/GTV + 2 mm. Relaxometry and diffusion-weighted imaging were implemented using clinically available sequences. Test-retest measurements were performed in eight patients, at each treatment fraction. Bias and uncertainty in relaxometry measurements were also assessed using a reference phantom. Results: The bias in longitudinal/transverse relaxation times was negligible while uncertainty was within 3 %. Test-retest measurements demonstrate that bias/uncertainty in patient T1 and T2 were comparable to bias/uncertainty estimated in the phantom. Mean T1 and T2 relaxation were significantly different between the prostate and DIL. The correlation between T1, T2, and diffusion was significant in the DIL, but not in the prostate. During treatment, mean T1 in the DIL approaches mean T1 in the prostate. Conclusions: Longitudinal relaxometry for online MR-guided adaptive SBRT is feasible in a high-field MR-Linac and may provide complementary information for target delineation and response assessment. © 2024 The Authors |
| Keywords: | adult; clinical article; treatment response; aged; intensity modulated radiation therapy; cancer patient; cancer radiotherapy; comparative study; radiotherapy dosage; radiotherapy; cohort analysis; prostate cancer; prostate; feasibility study; radiation dose fractionation; measurement; test retest reliability; seminal vesicle; stereotactic body radiation therapy; radiation dose distribution; diffusion weighted imaging; longitudinal study; prostate disease; gross tumor volume; clinical target volume; intermediate risk patient; uncertainty; image guided radiotherapy; apparent diffusion coefficient; adaptive radiotherapy; relaxation time; lesions and defects; multiparametric magnetic resonance imaging; human; male; article; quantitative mri; statistical bias; mr-linac; t2 weighted imaging; t1 weighted imaging; relaxometry; dominant intraprostatic lesion; limit of agreement; online adaptive radiotherapy |
| Journal Title: | Physics and Imaging in Radiation Oncology |
| Volume: | 32 |
| ISSN: | 2405-6316 |
| Publisher: | Elsevier B.V. |
| Date Published: | 2024-10-01 |
| Start Page: | 100678 |
| Language: | English |
| DOI: | 10.1016/j.phro.2024.100678 |
| PROVIDER: | scopus |
| PMCID: | PMC11665667 |
| PUBMED: | 39717186 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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