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Impact of magnetic resonance imaging-related geometric distortion of dose distribution in fractionated stereotactic radiotherapy in patients with brain metastases

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Abstract

Purpose

The geometric distortion related to magnetic resonance (MR) imaging in a diagnostic radiology (MRDR) and radiotherapy (MRRT) setup is evaluated, and the dosimetric impact of MR distortion on fractionated stereotactic radiotherapy (FSRT) in patients with brain metastases is simulated.

Materials and methods

An anthropomorphic skull phantom was scanned using a 1.5‑T MR scanner, and the magnitude of MR distortion was calculated with (MRDR-DC and MRRT-DC) and without (MRDR-nDC and MRRT-nDC) distortion-correction algorithms. Automated noncoplanar volumetric modulated arc therapy (HyperArc, HA; Varian Medical Systems, Palo Alto, CA, USA) plans were generated for 53 patients with 186 brain metastases. The MR distortion at each gross tumor volume (GTV) was calculated using the distance between the center of the GTV and the MR image isocenter (MIC) and the quadratic regression curve derived from the phantom study (MRRT-DC and MRRT-nDC). Subsequently, the radiation isocenter of the HA plans was shifted according to the MR distortion at each GTV (HADC and HAnDC).

Results

The median MR distortions were approximately 0.1 mm when the distance from the MIC was < 30 mm, whereas the median distortion varied widely when the distance was > 60 mm (0.23, 0.47, 0.37, and 0.57 mm in MRDR-DC, MRDR-nDC, MRRT-DC, and MRRT-nDC, respectively). The dose to the 98% of the GTV volume (D98%) decreased as the distance from the MIC increased. In the HADC plans, the relative dose difference of D98% was less than 5% when the GTV was located within 70 mm from the MIC, whereas the underdose of GTV exceeded 5% when it was 48 mm (−26.5% at maximum) away from the MIC in the HAnDC plans.

Conclusion

Use of a distortion-correction algorithm in the studied MR diagnoses is essential, and the dosimetric impact of MR distortion is not negligible, particularly for tumors located far away from the MIC.

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Abbreviations

AP:

Anterior–posterior

CT:

Computed tomography

DC:

Distortion correction

DX% :

Dose to the X% volume of the gross tumor volume

FSRT:

Fractionated stereotactic radiotherapy

GTV:

Gross tumor volume

HA:

HyperArc

HADC :

HyperArc plan simulating the impact of MR distortion with DC

HAnDC :

HyperArc plan simulating impact of MR distortion without DC

LR:

Left–right

MIC:

MR image isocenter

MR:

Magnetic resonance

MRDR :

MR image in diagnostic radiology setup

MRDR-DC:

MR image in diagnostic radiology setup with DC

MRDR-nDC:

MR image in diagnostic radiology setup without DC

MRRT :

MR image in radiotherapy setup

MRRT-DC:

MR image in radiotherapy setup with DC

MRRT-nDC:

MR image in radiotherapy setup without DC

PTV:

Planning target volume

RIC:

Radiation isocenter

ShiftAP :

Positional shift of GTV due to MR distortion in the AP direction

ShiftLR :

Positional shift of GTV due to MR distortion in the LR direction

ShiftSI :

Positional shift of GTV due to MR distortion in the superior-inferior direction

SI:

Superior–posterior

SRS:

Stereotactic radiosurgery

TC:

Tumor center

WBRT:

Whole-brain radiotherapy

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Funding

This study was supported by a JSPS KAKENHI grant (Grant-in-Aid for Scientific Research (C) 21K07742).

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Authors and Affiliations

  1. Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan

    Shingo Ohira, Shoki Inui, Naoyuki Kanayama, Masayoshi Miyazaki & Koji Konishi

  2. Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan

    Shingo Ohira, Yuki Yamamoto, Teiji Nishio & Masahiko Koizumi

  3. Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan

    Yuta Suzuki, Hayate Washio, Soichiro Tateishi, Minoru Kawamata & Katsuyuki Nakanishi

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  1. Shingo Ohira
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  2. Yuta Suzuki
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All authors participated in the writing of this article and took responsibility for its content. The authors confirm that the content of this manuscript has not been published or submitted for publication elsewhere.

Corresponding author

Correspondence to Shingo Ohira.

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Conflict of interest

S. Ohira, Y. Suzuki, H. Washio, Y. Yamamoto, S. Tateishi, S. Inui, N. Kanayama, M. Kawamata, M. Miyazaki, T. Nishio, M. Koizumi, K. Nakanishi, and K. Konishi declare that they have no competing interests.

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For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Ohira, S., Suzuki, Y., Washio, H. et al. Impact of magnetic resonance imaging-related geometric distortion of dose distribution in fractionated stereotactic radiotherapy in patients with brain metastases. Strahlenther Onkol 200, 39–48 (2024). https://doi.org/10.1007/s00066-023-02120-7

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