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Abdominal synthetic CT reconstruction with intensity projection prior for MRI-only adaptive radiotherapy

Authors
 Sven Olberg  ;  Jaehee Chun  ;  Byong Su Choi  ;  Inkyung Park  ;  Hyun Kim  ;  Taeho Kim  ;  Jin Sung Kim  ;  Olga Green  ;  Justin C Park 
Citation
 PHYSICS IN MEDICINE AND BIOLOGY, Vol.66 : 204001, 2021-10 
Journal Title
PHYSICS IN MEDICINE AND BIOLOGY
ISSN
 0031-9155 
Issue Date
2021-10
Keywords
MRI-guided ART ; deep learning ; synthetic CT
Abstract
Objective. Owing to the superior soft tissue contrast of MRI, MRI-guided adaptive radiotherapy (ART) is well-suited to managing interfractional changes in anatomy. An MRI-only workflow is desirable, but producing synthetic CT (sCT) data through paired data-driven deep learning (DL) for abdominal dose calculations remains a challenge due to the highly variable presence of intestinal gas. We present the preliminary dosimetric evaluation of our novel approach to sCT reconstruction that is well suited to handling intestinal gas in abdominal MRI-only ART.Approach. We utilize a paired data DL approach enabled by the intensity projection prior, in which well-matching training pairs are created by propagating air from MRI to corresponding CT scans. Evaluations focus on two classes: patients with (1) little involvement of intestinal gas, and (2) notable differences in intestinal gas presence between corresponding scans. Comparisons between sCT-based plans and CT-based clinical plans for both classes are made at the first treatment fraction to highlight the dosimetric impact of the variable presence of intestinal gas.Main results. Class 1 patients (n= 13) demonstrate differences in prescribed dose coverage of the PTV of 1.3 ± 2.1% between clinical plans and sCT-based plans. Mean DVH differences in all structures for Class 1 patients are found to be statistically insignificant. In Class 2 (n= 20), target coverage is 13.3 ± 11.0% higher in the clinical plans and mean DVH differences are found to be statistically significant.Significance. Significant deviations in calculated doses arising from the variable presence of intestinal gas in corresponding CT and MRI scans result in uncertainty in high-dose regions that may limit the effectiveness of adaptive dose escalation efforts. We have proposed a paired data-driven DL approach to sCT reconstruction for accurate dose calculations in abdominal ART enabled by the creation of a clinically unavailable training data set with well-matching representations of intestinal gas.
Full Text
https://iopscience.iop.org/article/10.1088/1361-6560/ac279e
DOI
10.1088/1361-6560/ac279e
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jinsung(김진성) ORCID logo https://orcid.org/0000-0003-1415-6471
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187055
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