Med Phys
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Fast spin echo (FSE) trains elicited by nonselective "hard" refocusing radio frequency (RF) pulses have been proposed as a means to enable application of FSE methods for high-resolution 3D magnetic resonance imaging (MRI). Hard-pulse FSE (HPFSE) trains offer short (3-4 ms) echo spacings, but are unfortunately limited to imaging the entire sample within the coil sensitivity thus requiring lengthy imaging times, consequently limiting clinical application. In this work we formulate and analyze two general-purpose combinations of 3D HPFSE with inner volume (IV) MR imaging to circumvent this limitation. ⋯ The methods as implemented achieve 95% to 97% outer volume signal suppression, and higher suppression appears to be well within reach, by further refinement of the selective RF excitations. Example images of the human brain and spine are presented with each technique. We conclude that the SNR efficiency of volume imaging in conjunction with the short echo spacing afforded by hard pulse trains enables high-resolution 3D HPFSE MRI of a small field-of-view (FOV) with minimal aliasing artifact.
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1H magnetic resonance spectroscopic imaging (MRSI) can improve the accuracy of target delineation for gliomas, but it lacks the anatomic resolution needed for image fusion. This paper presents a simple protocol for fusing simulation computer tomography (CT) and MRSI images for glioma intensity-modulated radiotherapy (IMRT), including a retrospective study of 12 patients. Each patient first underwent whole-brain axial fluid-attenuated-inversion-recovery (FLAIR) MRI (3 mm slice thickness, no spacing), followed by three-dimensional (3D) MRSI measurements (TE/TR: 144/1000 ms) of a user-specified volume encompassing the extent of the tumor. ⋯ The average agreement of the MRSI volume position on the screen-dumped MRSI images and the merged MRSI images was 0.29 mm with a standard deviation of 0.07 mm. Of all the voxels with Cho/Cr grade one or above, the distribution of Cho/Cr grade was found to correlate with the glioma grade from pathologic finding and is consistent with literature results indicating Cho/Cr elevation as a marker for malignancy. In conclusion, an image-fusion protocol was developed that successfully incorporates MRSI information into the IMRT treatment plan for glioma.
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Comparative Study Clinical Trial Controlled Clinical Trial
Use and uncertainties of mutual information for computed tomography/ magnetic resonance (CT/MR) registration post permanent implant of the prostate.
Post-implant dosimetric analysis for permanent implant of the prostate benefits from the use of a computed tomography (CT) dataset for optimal identification of the radioactive source (seed) positions and a magnetic resonance (MR) dataset for optimal description of the target and normal tissue volumes. The CT/MR registration process should be fast and sufficiently accurate to yield a reliable dosimetric analysis. Since critical normal tissues typically reside in dose gradient regions, small shifts in the dose distribution could impact the prediction of complication or complication severity. ⋯ Registration methods as applied here using mutual information and seed matching are consistent, except for a small systematic difference in the inferior-superior axis for a minority of cases (approximately 15%). Cases registered with mutual information and with bony anatomy misregistration of greater than approximately 5 mm should be evaluated for rescan or seed-match registration. The improvement in efficiency of use for the MI registration method is substantial, approximately 30 min compared to several hours using seed match registration.
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Comparative Study
Dosimetric study using different leaf-width MLCs for treatment planning of dynamic conformal arcs and intensity-modulated radiosurgery.
This paper systematically studied the dosimetric difference between a 3 mm micro multileaf collimator (MLC), a 5 mm MLC, and a 10 mm MLC for stereotactic radiosurgery using the Brainscan treatment planning system. Thirty-four cases treated with the dynamic conformal arcs technique and 20 cases treated with the intensity modulated radiosurgery/fractionated radiotherapy (IMRS/ IMRT) technique were retrospectively studied. The conformity index, the percentage target coverage, and the dose-volume histogram (DVH) for organs-at-risk (OARs) were used for dosimetric analysis and comparison for different treatment techniques, target volumes, and treatment sites. ⋯ The results suggest that for the dynamic conformal arcs technique, the narrower leaf-width MLC provides better dose conformity than the wider leaf-width MLCs. This advantage decreases when the target volume increases. For the IMRS/IMRT technique, the narrower leaf-width MLC could have better sparing of small OARs than the wider leaf-width MLC.