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Title: SU-C-18A-05: Registration Accuracy of MR-Based Images to On-Board Megavoltage Cone-Beam CT for Brain Patient Setup

Journal Article · · Medical Physics
DOI:https://doi.org/10.1118/1.4887832· OSTI ID:22333955
; ; ;  [1];  [2]
  1. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States)
  2. Global MR Applications and Workflow, GE Healthcare, Houston, TX (United States)

Purpose: To quantify the difference in isocenter shifts when co-registering MR and MR-based pseudo CTs (pCT) with on-board megavoltage conebeam CT (CBCT) images. Methods: Fast Spoiled Gradient Echo MRs were used to generate pCTs (research version of Advantage Sim MD™, GE Healthcare) for ten patients who had prior brain radiotherapy. The planning CT (rCT) for each was co-registered with the MR, and the plan isocenter and two other reference points were transferred to the MR and pCT. CBCT images (with the machine isocenter) from a single treatment day were coregistered with the 3 test images (MR, pCT and rCT), by two observers and by an automated registration algorithm. The reference points were used to calculate patient shifts and rotations from the registrations. The shifts calculated from the test image registrations were compared to each other and to the shifts performed by the therapists who treated the patients on that day. Results: The average difference in absolute value between the isocenter shifts from the MR-, pCT- and rCT-CBCT registrations, and the therapist shifts, were 2.02, 3.01 and 0.89 mm (craniocaudal), 1.14, 1.34 and 0.46 mm (lateral), and 1.37, 3.43 and 1.43 mm (vertical), respectively. The MR- and pCT-CBCT registrations differed by 1.99, and 2.53 mm (craniocaudal), 1.36, and 1.37 mm (lateral), and 0.74 and 2.34 mm (vertical), respectively, from the average rCT-CBCT shifts. On average, differences of 2.39 (craniocaudal), 1.28 (lateral) and 2.84 mm (vertical) were seen between the MR and pCT shifts. Rotations relative to the CBCT coordinate system were on average <2° for the MR and rCT, and <6° for the pCT. Conclusion: In this study, FSPGR MR-CBCT registrations were more precise compared to the pCT-CBCT registrations. For improved accuracy, MR sequences that are optimal for bony anatomy visualization are necessary. GE healthcare has provided a research version of Advantage Sim MD to UCSF. No financial support was provided.

OSTI ID:
22333955
Journal Information:
Medical Physics, Vol. 41, Issue 6; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-2405
Country of Publication:
United States
Language:
English