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Title: SU-F-J-172: Hybrid MR/CT Compatible Phantom for MR-Only Based Radiotherapy

Abstract

Purpose: Development of hybrid MR/CT compatible phantom was introduced to fully establish MR image only radiation treatment and this suggested technique using in-house developed hybrid MR/CT compatible phantom image would utilize to generate radiation treatment planning and perform dose calculation without multi-modal registration process or generation of pseudo CT. Methods: Fundamental characteristics for “hybrid MR/CT compatible phantom” was established: Relaxation times equivalent to human tissue, dielectric properties, homogeneous relaxation times, sufficient strength to fabricate a torso, ease of handling, a wide variety of density material for calibration, chemical and physical stability over an extended time. For this requirements, chemical component in each tested plug which would be tissue equivalent to human tissue on MR and CT image and production of phantom body and plug was performed. Chemical component has described below: Agaros, GdCl{sub 3}, NaN{sub 3}, NaCl, K{sub 2}Co{sub 3}, deionized-distilled water. Various mixture of chemical component to simulate human tissue on both MR and CT image was tested by measuring T1, T2 relaxation time and signal intensity (SI) on MR image and Hounsfield unit (HU) on CT and each value was compared. The hybrid MR/CT compatible phantom with 14 plugs was designed and has made. Total height and externalmore » diameter was decided by internal size of 32 channel MR head-coil. Results: Tissue-equivalent chemical component materials and hybrid MR/CT compatible phantom was developed. The range of T1, T2 relaxation time and SI on MR image, HU on CT was acquired and could be adjusted to correspond to simulated human tissue. Conclusion: Current result shows its possibility for MR-only based radiotherapy and the best mixing rate of chemical component for tissue-equivalent image on MR and CT was founded. However, additional technical issues remain to be overcome. Conversion of SI on MR image into HU and dose calculation based on converted MRI will be progressing.« less

Authors:
; ; ; ;  [1]
  1. Department of Biomedical Engineering, Research Institute of Biomedical Engineering, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)
Publication Date:
OSTI Identifier:
22634769
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ANIMAL TISSUES; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; DIELECTRIC MATERIALS; IMAGE PROCESSING; IMAGES; NMR IMAGING; PHANTOMS; RADIOTHERAPY

Citation Formats

Kim, M, Lee, S, Song, K, Park, S, and Suh, T. SU-F-J-172: Hybrid MR/CT Compatible Phantom for MR-Only Based Radiotherapy. United States: N. p., 2016. Web. doi:10.1118/1.4956080.
Kim, M, Lee, S, Song, K, Park, S, & Suh, T. SU-F-J-172: Hybrid MR/CT Compatible Phantom for MR-Only Based Radiotherapy. United States. doi:10.1118/1.4956080.
Kim, M, Lee, S, Song, K, Park, S, and Suh, T. Wed . "SU-F-J-172: Hybrid MR/CT Compatible Phantom for MR-Only Based Radiotherapy". United States. doi:10.1118/1.4956080.
@article{osti_22634769,
title = {SU-F-J-172: Hybrid MR/CT Compatible Phantom for MR-Only Based Radiotherapy},
author = {Kim, M and Lee, S and Song, K and Park, S and Suh, T},
abstractNote = {Purpose: Development of hybrid MR/CT compatible phantom was introduced to fully establish MR image only radiation treatment and this suggested technique using in-house developed hybrid MR/CT compatible phantom image would utilize to generate radiation treatment planning and perform dose calculation without multi-modal registration process or generation of pseudo CT. Methods: Fundamental characteristics for “hybrid MR/CT compatible phantom” was established: Relaxation times equivalent to human tissue, dielectric properties, homogeneous relaxation times, sufficient strength to fabricate a torso, ease of handling, a wide variety of density material for calibration, chemical and physical stability over an extended time. For this requirements, chemical component in each tested plug which would be tissue equivalent to human tissue on MR and CT image and production of phantom body and plug was performed. Chemical component has described below: Agaros, GdCl{sub 3}, NaN{sub 3}, NaCl, K{sub 2}Co{sub 3}, deionized-distilled water. Various mixture of chemical component to simulate human tissue on both MR and CT image was tested by measuring T1, T2 relaxation time and signal intensity (SI) on MR image and Hounsfield unit (HU) on CT and each value was compared. The hybrid MR/CT compatible phantom with 14 plugs was designed and has made. Total height and external diameter was decided by internal size of 32 channel MR head-coil. Results: Tissue-equivalent chemical component materials and hybrid MR/CT compatible phantom was developed. The range of T1, T2 relaxation time and SI on MR image, HU on CT was acquired and could be adjusted to correspond to simulated human tissue. Conclusion: Current result shows its possibility for MR-only based radiotherapy and the best mixing rate of chemical component for tissue-equivalent image on MR and CT was founded. However, additional technical issues remain to be overcome. Conversion of SI on MR image into HU and dose calculation based on converted MRI will be progressing.},
doi = {10.1118/1.4956080},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: To develop an image processing method for MRI-based generation of electron density maps, known as pseudo-CT (pCT), without usage of model- or atlas-based segmentation, and to evaluate the method in the pelvic and head-neck region against CT. Methods: CT and MRI scans were obtained from the pelvic region of four patients in supine position using a flat table top only for CT. Stratified CT maps were generated by classifying each voxel based on HU ranges into one of four classes: air, adipose tissue, soft tissue or bone.A hierarchical region-selective algorithm, based on automatic thresholding and clustering, was used tomore » classify tissues from MR Dixon reconstructed fat, In-Phase (IP) and Opposed-Phase (OP) images. First, a body mask was obtained by thresholding the IP image. Subsequently, an automatic threshold on the Dixon fat image differentiated soft and adipose tissue. K-means clustering on IP and OP images resulted in a mask that, via a connected neighborhood analysis, allowing the user to select the components corresponding to bone structures.The pCT was estimated through assignment of bulk HU to the tissue classes. Bone-only Digital Reconstructed Radiographs (DRR) were generated as well. The pCT images were rigidly registered to the stratified CT to allow a volumetric and voxelwise comparison. Moreover, pCTs were also calculated within the head-neck region in two volunteers using the same pipeline. Results: The volumetric comparison resulted in differences <1% for each tissue class. A voxelwise comparison showed a good classification, ranging from 64% to 98%. The primary misclassified classes were adipose/soft tissue and bone/soft tissue. As the patients have been imaged on different table tops, part of the misclassification error can be explained by misregistration. Conclusion: The proposed approach does not rely on an anatomy model providing the flexibility to successfully generate the pCT in two different body sites. This research is founded by ZonMw IMDI Programme, project name: “RASOR sharp: MRI based radiotherapy planning using a single MRI sequence”, project number: 10-104003010.« less
  • Purpose: To develop and validate a 4 class tissue segmentation approach (air cavities, background, bone and soft-tissue) on T1 -weighted brain MRI and to create a pseudo-CT for MRI-only radiation therapy verification. Methods: Contrast-enhanced T1-weighted fast-spin-echo sequences (TR = 756ms, TE= 7.152ms), acquired on a 1.5T GE MRI-Simulator, are used.MRIs are firstly pre-processed to correct for non uniformity using the non parametric, non uniformity intensity normalization algorithm. Subsequently, a logarithmic inverse scaling log(1/image) is applied, prior to segmentation, to better differentiate bone and air from soft-tissues. Finally, the following method is enrolled to classify intensities into air cavities, background, bonemore » and soft-tissue:Thresholded region growing with seed points in image corners is applied to get a mask of Air+Bone+Background. The background is, afterward, separated by the scan-line filling algorithm. The air mask is extracted by morphological opening followed by a post-processing based on knowledge about air regions geometry. The remaining rough bone pre-segmentation is refined by applying 3D geodesic active contours; bone segmentation evolves by the sum of internal forces from contour geometry and external force derived from image gradient magnitude.Pseudo-CT is obtained by assigning −1000HU to air and background voxels, performing linear mapping of soft-tissue MR intensities in [-400HU, 200HU] and inverse linear mapping of bone MR intensities in [200HU, 1000HU]. Results: Three brain patients having registered MRI and CT are used for validation. CT intensities classification into 4 classes is performed by thresholding. Dice and misclassification errors are quantified. Correct classifications for soft-tissue, bone, and air are respectively 89.67%, 77.8%, and 64.5%. Dice indices are acceptable for bone (0.74) and soft-tissue (0.91) but low for air regions (0.48). Pseudo-CT produces DRRs with acceptable clinical visual agreement to CT-based DRR. Conclusion: The proposed approach makes it possible to use T1-weighted MRI to generate accurate pseudo-CT from 4-class segmentation.« less
  • Purpose: To compare the accuracy of CT-MR registration using a mutual information method with registration using a frame-based localizer box. Methods: Ten patients having the Leksell head frame and scanned with a modality specific localizer box were imported into the treatment planning system. The fiducial rods of the localizer box were contoured on both the MR and CT scans. The skull was contoured on the CT images. The MR and CT images were registered by two methods. The frame-based method used the transformation that minimized the mean square distance of the centroids of the contours of the fiducial rods frommore » a mathematical model of the localizer. The mutual information method used automated image registration tools in the TPS and was restricted to a volume-of-interest defined by the skull contours with a 5 mm margin. For each case, the two registrations were adjusted by two evaluation teams, each comprised of an experienced radiation oncologist and neurosurgeon, to optimize alignment in the region of the brainstem. The teams were blinded to the registration method. Results: The mean adjustment was 0.4 mm (range 0 to 2 mm) and 0.2 mm (range 0 to 1 mm) for the frame and mutual information methods, respectively. The median difference between the frame and mutual information registrations was 0.3 mm, but was not statistically significant using the Wilcoxon signed rank test (p=0.37). Conclusion: The difference between frame and mutual information registration techniques was neither statistically significant nor, for most applications, clinically important. These results suggest that mutual information is equivalent to frame-based image registration for radiosurgery. Work is ongoing to add additional evaluators and to assess the differences between evaluators.« less
  • Purpose: Investigating a new approach in MRI based treatment planning using the combination of (Ultrashort Echo Time) UTE and T1 weighted spin echo pulse sequences to delineate air, bone and water (soft tissues) in generating pseudo CT images comparable with CT. Methods: A gel phantom containing chicken bones, ping pang balls filled with distilled water and air bubbles, was made. It scanned with MRI using UTE and 2D T1W SE pulse sequences with (in plane resolution= 0.53mm, slice thickness= 2 mm) and CT with (in plane resolution= 0.5 mm and slice thickness= 0.75mm) as a ground truth for geometrical accuracy.more » The UTE and T1W SE images were registered with CT using mutual information registration algorithm provided by Philips Pinnacle treatment planning system. The phantom boundaries were detected using Canny edge detection algorithm for CT, and MR images. The bone, air bubbles and water in ping pong balls were segmented from CT images using threshold 300HU, - 950HU and 0HU, respectively. These tissue inserts were automatically segmented from combined UTE and T1W SE images using edge detection and relative intensity histograms of the phantom. The obtained segmentations of air, bone and water inserts were evaluated with those obtained from CT. Results: Bone and air can be clearly differentiated in UTE images comparable to CT. Combining UTE and T1W SE images successfully segmented the air, bone and water. The maximum segmentation differences from combine MRI images (UTE and T1W SE) and CT are within 1.3 mm, 1.1mm for bone, air, respectively. The geometric distortion of UTE sequence is small less than 1 pixel (0.53 mm) of MR image resolution. Conclusion: Our approach indicates that MRI can be used solely for treatment planning and its quality is comparable with CT.« less
  • Purpose: To investigate the feasibility of using TMR ratio correction factors for a fast online adaptive plan to compensate for anatomical changes in stereotactic radiosurgery (SRS) of L-spine tumors. Methods: Three coplanar treatment plans were made for 11 patients: Uniform (9 IMRT beams equally distributed around the patient); Posterior (IMRT with 9 posterior beams every 20 degree) and VMAT (2 360° arcs). For each patient, the external body and bowel gas were contoured on the planning CT and pre-treatment CBCT. After registering CBCT and the planning CT by aligning to the tumor, the CBCT contours were transferred to the planningmore » CT. To estimate the actual delivered dose while considering patient’s anatomy of the treatment day, a hybrid CT was created by overriding densities in planning CT using the differences between CT and CBCT external and bowel gas contours. Correction factors (CF) were calculated using the effective depth information obtained from the planning system using the hybrid CT: CF = TMR (delivery)/TMR (planning). The adaptive plan was generated by multiplying the planned Monitor Units with the CFs. Results: The mean absolute difference (MAD) in V16Gy of the target between planned and estimated delivery with and without TMR correction was 0.8 ± 0.7% vs. 2.4 ± 1.3% for Uniform and 1.0 ± 0.9% vs. 2.6 ± 1.3% for VMAT plans(p<0.05), respectively. For V12Gy of cauda-equina with and without TMR correction, MAD was 0.24 ± 0.19% vs. 1.2 ± 1.02% for Uniform and 0.23 ± 0.20% vs. 0.78 ± 0.79% for VMAT plans(p<0.05), respectively. The differences between adaptive and original plans were not significant for posterior plans. Conclusion: The online adaptive strategy using TMR ratios and pre-treatment CBCT information was feasible strategy to compensate for anatomical changes for the patients treated for L-spine tumors, particularly for equally spaced IMRT and VMAT plans.« less