Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator
Background and purpose: Magnetic resonance imaging integrated linear accelerator (MR-Linac) platforms enable acquisition of diffusion weighted imaging (DWI) during treatment providing potential information about treatment response. Obtaining DWI on these platforms is technically different from diagn...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Physics and Imaging in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405631622000513 |
| _version_ | 1828109069238403072 |
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| author | Manasi Ingle Matthew Blackledge Ingrid White Andreas Wetscherek Susan Lalondrelle Shaista Hafeez Shreerang Bhide |
| author_facet | Manasi Ingle Matthew Blackledge Ingrid White Andreas Wetscherek Susan Lalondrelle Shaista Hafeez Shreerang Bhide |
| author_sort | Manasi Ingle |
| collection | DOAJ |
| description | Background and purpose: Magnetic resonance imaging integrated linear accelerator (MR-Linac) platforms enable acquisition of diffusion weighted imaging (DWI) during treatment providing potential information about treatment response. Obtaining DWI on these platforms is technically different from diagnostic magnetic resonance imaging (MRI) scanners. The aim of this project was to determine feasibility of obtaining DWI and calculating apparent diffusion coefficient (ADC) parameters longitudinally in rectal cancer patients on the MR-Linac. Materials and methods: Nine patients undergoing treatment on MR-Linac had DWI acquired using b-values 0, 30, 150, 500 s/mm2. Gross tumour volume (GTV) and normal tissue was delineated on DWI throughout treatment and median ADC was calculated using an in-house tool (pyOsirix ®). Results: Seven out of nine patients were included in the analysis; all demonstrated downstaging at follow-up. A total of 63 out of 70 DWI were analysed (7 excluded due to poor image quality). An increasing trend of ADC median for GTV (1.15 × 10−3 mm2/s interquartile range (IQ): 1.05–1.17 vs 1.59 × 10−3 mm2/s IQ: 1.37 – 1.64; p = 0.0156), correlating to treatment response. In comparison ADC median for normal tissue remained the same between first and last fraction (1.61 × 10−3 mm2/s IQ: 1.56–1.71 vs 1.67 × 10−3 mm2/s IQ: 1.37–2.00; p = 0.9375). Conclusions: DWI assessment in rectal cancer patients on MR-Linac is feasible. Initial results provide foundations for further studies to determine DWI use for treatment adaptation in rectal cancer. |
| first_indexed | 2024-04-11T10:56:54Z |
| format | Article |
| id | doaj.art-e20451d3f80f44a294e6dbefcb073b68 |
| institution | Directory Open Access Journal |
| issn | 2405-6316 |
| language | English |
| last_indexed | 2024-04-11T10:56:54Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Physics and Imaging in Radiation Oncology |
| spelling | doaj.art-e20451d3f80f44a294e6dbefcb073b682022-12-22T04:28:44ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162022-07-01233237Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear acceleratorManasi Ingle0Matthew Blackledge1Ingrid White2Andreas Wetscherek3Susan Lalondrelle4Shaista Hafeez5Shreerang Bhide6The Royal Marsden Hospital NHS Trust, 203 Fulham Road, London SW3 6JJ, UK; The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK; Corresponding author at: The Institute of Cancer Research, SM2 5NG, UK.The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UKGuys and St Thomas NHS Trust, Great Maze Pond, London SE1 9RT, UKThe Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UKThe Royal Marsden Hospital NHS Trust, 203 Fulham Road, London SW3 6JJ, UK; The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UKThe Royal Marsden Hospital NHS Trust, 203 Fulham Road, London SW3 6JJ, UK; The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UKThe Royal Marsden Hospital NHS Trust, 203 Fulham Road, London SW3 6JJ, UK; The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UKBackground and purpose: Magnetic resonance imaging integrated linear accelerator (MR-Linac) platforms enable acquisition of diffusion weighted imaging (DWI) during treatment providing potential information about treatment response. Obtaining DWI on these platforms is technically different from diagnostic magnetic resonance imaging (MRI) scanners. The aim of this project was to determine feasibility of obtaining DWI and calculating apparent diffusion coefficient (ADC) parameters longitudinally in rectal cancer patients on the MR-Linac. Materials and methods: Nine patients undergoing treatment on MR-Linac had DWI acquired using b-values 0, 30, 150, 500 s/mm2. Gross tumour volume (GTV) and normal tissue was delineated on DWI throughout treatment and median ADC was calculated using an in-house tool (pyOsirix ®). Results: Seven out of nine patients were included in the analysis; all demonstrated downstaging at follow-up. A total of 63 out of 70 DWI were analysed (7 excluded due to poor image quality). An increasing trend of ADC median for GTV (1.15 × 10−3 mm2/s interquartile range (IQ): 1.05–1.17 vs 1.59 × 10−3 mm2/s IQ: 1.37 – 1.64; p = 0.0156), correlating to treatment response. In comparison ADC median for normal tissue remained the same between first and last fraction (1.61 × 10−3 mm2/s IQ: 1.56–1.71 vs 1.67 × 10−3 mm2/s IQ: 1.37–2.00; p = 0.9375). Conclusions: DWI assessment in rectal cancer patients on MR-Linac is feasible. Initial results provide foundations for further studies to determine DWI use for treatment adaptation in rectal cancer.http://www.sciencedirect.com/science/article/pii/S2405631622000513MR-LinacMRIDiffusion weighted imagingApparent diffusion coefficientRectal cancer |
| spellingShingle | Manasi Ingle Matthew Blackledge Ingrid White Andreas Wetscherek Susan Lalondrelle Shaista Hafeez Shreerang Bhide Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator Physics and Imaging in Radiation Oncology MR-Linac MRI Diffusion weighted imaging Apparent diffusion coefficient Rectal cancer |
| title | Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| title_full | Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| title_fullStr | Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| title_full_unstemmed | Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| title_short | Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| title_sort | quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator |
| topic | MR-Linac MRI Diffusion weighted imaging Apparent diffusion coefficient Rectal cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2405631622000513 |
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