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Published in: Radiation Oncology 1/2009

Open Access 01-12-2009 | Research

Systematisation of spatial uncertainties for comparison between a MR and a CT-based radiotherapy workflow for prostate treatments

Authors: Tufve Nyholm, Morgan Nyberg, Magnus G Karlsson, Mikael Karlsson

Published in: Radiation Oncology | Issue 1/2009

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Abstract

Background

In the present work we compared the spatial uncertainties associated with a MR-based workflow for external radiotherapy of prostate cancer to a standard CT-based workflow. The MR-based workflow relies on target definition and patient positioning based on MR imaging. A solution for patient transport between the MR scanner and the treatment units has been developed. For the CT-based workflow, the target is defined on a MR series but then transferred to a CT study through image registration before treatment planning, and a patient positioning using portal imaging and fiducial markers.

Methods

An "open bore" 1.5T MRI scanner, Siemens Espree, has been installed in the radiotherapy department in near proximity to a treatment unit to enable patient transport between the two installations, and hence use the MRI for patient positioning. The spatial uncertainty caused by the transport was added to the uncertainty originating from the target definition process, estimated through a review of the scientific literature. The uncertainty in the CT-based workflow was estimated through a literature review.

Results

The systematic uncertainties, affecting all treatment fractions, are reduced from 3-4 mm (1Sd) with a CT based workflow to 2-3 mm with a MR based workflow. The main contributing factor to this improvement is the exclusion of registration between MR and CT in the planning phase of the treatment.

Conclusion

Treatment planning directly on MR images reduce the spatial uncertainty for prostate treatments.
Appendix
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Metadata
Title
Systematisation of spatial uncertainties for comparison between a MR and a CT-based radiotherapy workflow for prostate treatments
Authors
Tufve Nyholm
Morgan Nyberg
Magnus G Karlsson
Mikael Karlsson
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2009
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-4-54

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