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Contribution Details
| Type | Journal Article |
| Scope | Discipline-based scholarship |
| Title | Patient-specific quality assurance strategies for synthetic computed tomography in magnetic resonance-only radiotherapy of the abdomen |
| Organization Unit | |
| Authors |
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| Item Subtype | Original Work |
| Refereed | Yes |
| Status | Published in final form |
| Language |
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| Journal Title | Physics and imaging in radiation oncology |
| Publisher | Elsevier |
| Geographical Reach | international |
| ISSN | 2405-6316 |
| Volume | 27 |
| Page Range | 100464 |
| Date | 2023 |
| Abstract Text | BACKGROUND AND PURPOSE The superior tissue contrast of magnetic resonance (MR) compared to computed tomography (CT) led to an increasing interest towards MR-only radiotherapy. For the latter, the dose calculation should be performed on a synthetic CT (sCT). Patient-specific quality assurance (PSQA) methods have not been established yet and this study aimed to assess several software-based solutions. MATERIALS AND METHODS A retrospective study was performed on 20 patients treated at an MR-Linac, which were selected to evenly cover four subcategories: (i) standard, (ii) air pockets, (iii) lung and (iv) implant cases. The neural network (NN) CycleGAN was adopted to generate a reference sCT, which was then compared to four PSQA methods: (A) water override of body, (B) five tissue classes with bulk densities, (C) sCT generated by a separate NN (pix2pix) and (D) deformed CT. RESULTS The evaluation of the dose endpoints demonstrated that while all methods A-D provided statistically equivalent results (p = 0.05) within the 2% level for the standard cases (i), only the methods C-D guaranteed the same result over the whole cohort. The bulk densities override was shown to be a valuable method in absence of lung tissue within the beam path. CONCLUSION The observations of this study suggested that the use of an additional sCT generated by a separate NN was an appropriate tool to perform PSQA of a sCT in an MR-only workflow at an MR-Linac. The time and dose endpoints requirements were respected, namely within 10 min and 2%. |
| Free access at | DOI |
| Digital Object Identifier | 10.1016/j.phro.2023.100464 |
| PubMed ID | 37497188 |
| Other Identification Number | PMCID: PMC10366576; merlin-id:24374 |
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