PMID- 37285037
OWN - NLM
STAT- MEDLINE
DCOM- 20230724
LR  - 20230825
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Print)
IS  - 0179-7158 (Linking)
VI  - 199
IP  - 8
DP  - 2023 Aug
TI  - Synthetic CTs for MRI-only brain RT treatment: integration of immobilization 
      systems.
PG  - 739-748
LID - 10.1007/s00066-023-02090-w [doi]
AB  - PURPOSE: Auxiliary devices such as immobilization systems should be considered in 
      synthetic CT (sCT)-based treatment planning (TP) for MRI-only brain radiotherapy 
      (RT). A method for auxiliary device definition in the sCT is introduced, and its 
      dosimetric impact on the sCT-based TP is addressed. METHODS: T1-VIBE DIXON was 
      acquired in an RT setup. Ten datasets were retrospectively used for sCT 
      generation. Silicone markers were used to determine the auxiliary devices' 
      relative position. An auxiliary structure template (AST) was created in the TP 
      system and placed manually on the MRI. Various RT mask characteristics were 
      simulated in the sCT and investigated by recalculating the CT-based clinical plan 
      on the sCT. The influence of auxiliary devices was investigated by creating 
      static fields aimed at artificial planning target volumes (PTVs) in the CT and 
      recalculated in the sCT. The dose covering 50% of the PTV (D(50)) deviation 
      percentage between CT-based/recalculated plan (∆D(50)[%]) was evaluated. RESULTS: 
      Defining an optimal RT mask yielded a ∆D(50)[%] of 0.2 +/- 1.03% for the PTV and 
      between -1.6 +/- 3.4% and 1.1 +/- 2.0% for OARs. Evaluating each static field, the 
      largest ∆D(50)[%] was delivered by AST positioning inaccuracy (max: 3.5 +/- 2.4%), 
      followed by the RT table (max: 3.6 +/- 1.2%) and the RT mask (max: 3.0 +/- 0.8% 
      [anterior], 1.6 +/- 0.4% [rest]). No correlation between ∆D(50)[%] and beam depth 
      was found for the sum of opposing beams, except for (45 degrees  + 315 degrees ). CONCLUSION: 
      This study evaluated the integration of auxiliary devices and their dosimetric 
      influence on sCT-based TP. The AST can be easily integrated into the sCT-based 
      TP. Further, we found that the dosimetric impact was within an acceptable range 
      for an MRI-only workflow.
CI  - (c) 2023. The Author(s).
FAU - Masitho, Siti
AU  - Masitho S
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany. siti.masitho@fau.de.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany. 
      siti.masitho@fau.de.
FAU - Grigo, Johanna
AU  - Grigo J
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Brandt, Tobias
AU  - Brandt T
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Lambrecht, Ulrike
AU  - Lambrecht U
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Szkitsak, Juliane
AU  - Szkitsak J
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Weiss, Alexander
AU  - Weiss A
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Fietkau, Rainer
AU  - Fietkau R
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Putz, Florian
AU  - Putz F
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
FAU - Bert, Christoph
AU  - Bert C
AD  - Department of Radiation Oncology, Strahlenklinik, Universitatsklinikum Erlangen, 
      Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Universitatsstrasse 27, 
      91054, Erlangen, Germany.
AD  - Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230607
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - Radiotherapy Dosage
MH  - *Radiotherapy Planning, Computer-Assisted/methods
MH  - *Magnetic Resonance Imaging/methods
MH  - Brain/diagnostic imaging
PMC - PMC10361877
OTO - NOTNLM
OT  - Artificial intelligence
OT  - Image-guided radiotherapy
OT  - Radiotherapy setup
OT  - Stereotactic radiosurgery
OT  - Treatment planning
COIS- Universitatsklinikum Erlangen, Department of Radiotherapy and Siemens 
      Healthineers (Erlangen, Germany) have institutional contracts partly related to 
      this work. S. Masitho, J. Grigo, T. Brandt, U. Lambrecht, J. Szkitsak, A. Weiss, 
      R. Fietkau, F. Putz, and C. Bert declare that they have no competing interests.
EDAT- 2023/06/07 13:10
MHDA- 2023/07/24 06:42
PMCR- 2023/06/07
CRDT- 2023/06/07 11:15
PHST- 2022/12/29 00:00 [received]
PHST- 2023/04/25 00:00 [accepted]
PHST- 2023/07/24 06:42 [medline]
PHST- 2023/06/07 13:10 [pubmed]
PHST- 2023/06/07 11:15 [entrez]
PHST- 2023/06/07 00:00 [pmc-release]
AID - 10.1007/s00066-023-02090-w [pii]
AID - 2090 [pii]
AID - 10.1007/s00066-023-02090-w [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2023 Aug;199(8):739-748. doi: 10.1007/s00066-023-02090-w. 
      Epub 2023 Jun 7.