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Technical feasibility of integrating 7 T anatomical MRI in image-guided radiotherapy of glioblastoma: a preparatory study

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Abstract

Objectives

The use of 7 Tesla (T) magnetic resonance imaging (MRI) has recently shown great potential for high-resolution soft-tissue neuroimaging and visualization of microvascularization in glioblastoma (GBM). We have designed a clinical trial to explore the value of 7 T MRI in radiation treatment of GBM. For this aim we performed a preparatory study to investigate the technical feasibility of incorporating 7 T MR images into the neurosurgical navigation and radiotherapy treatment planning (RTP) systems via qualitative and quantitative assessment of the image quality.

Materials and methods

The MR images were acquired with a Siemens Magnetom 7 T whole-body scanner and a Nova Medical 32-channel head coil. The 7 T MRI pulse sequences included magnetization-prepared two rapid acquisition gradient echoes (MP2RAGE), T2-SPACE, SPACE-FLAIR and gradient echo sequences (GRE). A pilot study with three healthy volunteers and an anthropomorphic 3D phantom was used to assess image quality and geometrical image accuracy.

Results

The MRI scans were well tolerated by the volunteers. Susceptibility artefacts were observed in both the cortex and subcortical white matter at close proximity to air-tissue interfaces. Regional loss of signal and contrast could be minimized by the use of dielectric pads. Image transfer and processing did not degrade image quality. The system-related spatial uncertainty of geometrical distortion-corrected MP2RAGE pulse sequences was ≤2 mm.

Conclusion

Integration of high-quality and geometrically-reliable 7 T MR images into neurosurgical navigation and RTP software is technically feasible and safe.

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Acknowledgments

This research was partially supported by the Brains Unlimited Pioneer Fund of the Limburg University Fund/SWOL. We would like to thank B.G. Baumert MD, PhD, MBA, for her support with the study concept. Furthermore, we would like to thank the Support Team at Scannexus, Margo van de Wetering and Esther Steijvers, for their support in the acquisition and optimization of the 7 T MRI sequences.

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    Authors and Affiliations

    1. Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands

      Inge Compter, Jurgen Peerlings, Daniëlle B. P. Eekers, Philippe Lambin & Aswin L. Hoffmann

    2. Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands

      Jurgen Peerlings & Alida A. Postma

    3. Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands

      Dimo Ivanov

    4. Scannexus, Maastricht, The Netherlands

      Christopher J. Wiggins

    5. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands

      Pieter Kubben, Linda Ackermans & Olaf E. M. G. Schijns

    6. Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands

      Benno Küsters

    7. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands

      Benno Küsters & Pieter Wesseling

    8. Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands

      Pieter Wesseling

    9. Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany

      Aswin L. Hoffmann

    10. Department of Radiation Oncology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany

      Aswin L. Hoffmann

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    1. Inge Compter
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    Correspondence to Inge Compter.

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    Conflict of interest

    Inge Compter has received a research grant from the Brains Unlimited Pioneer Fund of the Limburg University Fund/SWOL. Jurgen Peerlings declares that he has no conflict of interest Daniëlle B.P. Eekers declares that she has no conflict of interest Alida A. Postma declares that she has no conflict of interest Dimo Ivanov declares that he has no conflict of interest Christopher J. Wiggins declares that he has no conflict of interest Pieter Kubben declares that he has no conflict of interest Benno Küsters declares that he has no conflict of interest Pieter Wesseling declares that he has no conflict of interest Linda Ackermans declares that she has no conflict of interest Olaf E.M.G. Schijns declares that he has no conflict of interest Philippe Lambin declares that he has no conflict of interest Aswin L. Hoffmann declares that he has no conflict of interest.

    Ethical approval

    The study was approved by the Medical Review Ethics Committee Maastricht UMC+ (Ethics code: 143018).

    Research involving human participants

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study. This trial is registered on clinicaltrials.gov (NCT02062372).

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    I. Compter and J. Peerlings contributed equally to this work.

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    Compter, I., Peerlings, J., Eekers, D.B.P. et al. Technical feasibility of integrating 7 T anatomical MRI in image-guided radiotherapy of glioblastoma: a preparatory study. Magn Reson Mater Phy 29, 591–603 (2016). https://doi.org/10.1007/s10334-016-0534-7

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