TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy

Heijst, T van; Asselen, B van; Lagendijk, J; Bongard, D van den; Philippens, M

doi:10.1118/1.4889551

Title: TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy

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Abstract

Purpose: In regional radiotherapy (RT) for breast-cancer patients, direct visualization of individual lymph nodes (LNs) may reduce target volumes and Result in lower toxicity (i.e. reduced radiation pneumonitis, arm edema, arm morbidity), relative to standard CT-based delineations. To this end, newly designed magnetic resonance imaging (MRI) sequences were optimized and assessed qualitatively and quantitatively. Methods: In ten healthy female volunteers, a scanning protocol was developed and optimized. Coronal images were acquired in supine RT position positioned on a wedge board on a 1.5 T Ingenia (Philips) wide-bore MRI. In four volunteers the optimized MRI protocol was applied, including a 3-dimensional (3D) T1-weighted (T1w) fast-field-echo (FFE). T2w sequences, including 3D FFE, 3D and 2D fast spin echo (FSE), and diffusion-weighted single-shot echo-planar imaging (DWI) were also performed. Several fatsuppression techniques were used. Qualitative evaluation parameters included LN contrast, motion susceptibility, visibility of anatomical structures, and fat suppression. The number of visible axillary and supraclavicular LNs was also determined. Results: T1 FFE, insensitive to motion, lacked contrast of LNs, which often blended in with soft tissue and blood. T2 FFE showed high contrast, but some LNs were obscured due to motion. Both 2D and 3D FSE were motion-insensitive having high contrast, althoughmore »« less

Authors:

Heijst, T van; Asselen, B van; Lagendijk, J; Bongard, D van den; Philippens, M ^[1]

University Medical Center Utrecht, Utrecht (Netherlands)

Publication Date:: Sun Jun 15 00:00:00 EDT 2014

OSTI Identifier:: 22409803

Resource Type:: Journal Article

Journal Name:: Medical Physics

Additional Journal Information:: Journal Volume: 41; Journal Issue: 6; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0094-2405

Country of Publication:: United States

Language:: English

Subject:: 60 APPLIED LIFE SCIENCES; COMPARATIVE EVALUATIONS; LYMPH NODES; MAMMARY GLANDS; NEOPLASMS; NMR IMAGING; PLANNING; PNEUMONITIS; RADIOTHERAPY; THREE-DIMENSIONAL CALCULATIONS; TOXICITY

Citation Formats


                    Heijst, T van, Asselen, B van, Lagendijk, J, Bongard, D van den, and Philippens, M. TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy.  United States: N. p., 2014. 
        Web.  doi:10.1118/1.4889551.

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                    Heijst, T van, Asselen, B van, Lagendijk, J, Bongard, D van den, & Philippens, M. TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy.  United States.  https://doi.org/10.1118/1.4889551

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                    Heijst, T van, Asselen, B van, Lagendijk, J, Bongard, D van den, and Philippens, M. 2014.  
        "TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy".  United States.  https://doi.org/10.1118/1.4889551.

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@article{osti_22409803,

  title        = {TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy},

  author       = {Heijst, T van and Asselen, B van and Lagendijk, J and Bongard, D van den and Philippens, M},

  abstractNote = {Purpose: In regional radiotherapy (RT) for breast-cancer patients, direct visualization of individual lymph nodes (LNs) may reduce target volumes and Result in lower toxicity (i.e. reduced radiation pneumonitis, arm edema, arm morbidity), relative to standard CT-based delineations. To this end, newly designed magnetic resonance imaging (MRI) sequences were optimized and assessed qualitatively and quantitatively. Methods: In ten healthy female volunteers, a scanning protocol was developed and optimized. Coronal images were acquired in supine RT position positioned on a wedge board on a 1.5 T Ingenia (Philips) wide-bore MRI. In four volunteers the optimized MRI protocol was applied, including a 3-dimensional (3D) T1-weighted (T1w) fast-field-echo (FFE). T2w sequences, including 3D FFE, 3D and 2D fast spin echo (FSE), and diffusion-weighted single-shot echo-planar imaging (DWI) were also performed. Several fatsuppression techniques were used. Qualitative evaluation parameters included LN contrast, motion susceptibility, visibility of anatomical structures, and fat suppression. The number of visible axillary and supraclavicular LNs was also determined. Results: T1 FFE, insensitive to motion, lacked contrast of LNs, which often blended in with soft tissue and blood. T2 FFE showed high contrast, but some LNs were obscured due to motion. Both 2D and 3D FSE were motion-insensitive having high contrast, although some blood remained visible. 2D FSE showed more anatomical details, while in 3D FSE, some blurring occurred. DWI showed high LN contrast, but suffered from geometric distortions and low resolution. Fat suppression by mDixon was the most reliable in regions with magnetic-field inhomogeneities. The FSE sequences showed the highest sensitivity for LN detection. Conclusion: MRI of regional LNs was achieved in volunteers. The FSE techniques were robust and the most sensitive. Our optimized MRI sequences can facilitate direct delineation of individual LNs. This can Result in smaller target volumes and reduced toxicity in regional RT compared to standard CT planning.},

  doi          = {10.1118/1.4889551},

  url          = {https://www.osti.gov/biblio/22409803},
  journal      = {Medical Physics},

  issn         = {0094-2405},

  number       = 6,

  volume       = 41,

  place        = {United States},

  year         = {Sun Jun 15 00:00:00 EDT 2014},

  month        = {Sun Jun 15 00:00:00 EDT 2014}

}

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