Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer

Background and purpose: Magnetic resonance imaging – linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.5 T MRI-linac in patients w...

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Main Authors: Michael J. Dubec, Michael Berks, James Price, Lisa McDaid, John Gaffney, Ross A. Little, Susan Cheung, Marcel van Herk, Ananya Choudhury, Julian C. Matthews, Andrew McPartlin, Geoff J.M. Parker, David L. Buckley, James P.B. O’Connor
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Physics and Imaging in Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405631624001593
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Summary:Background and purpose: Magnetic resonance imaging – linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.5 T MRI-linac in patients with head and neck cancer (HNC) and measured biomarker repeatability and sensitivity to radiotherapy effects. Materials and methods: Patients were imaged on a 1.5 T MRI-linac or a 1.5 T diagnostic MR system twice before treatment. DCE-MRI parameters including Ktrans were calculated, with the optimum pharmacokinetic model identified using corrected Akaike information criterion. Repeatability was assessed by within-subject coefficient of variation (wCV). Treatment effects were assessed as change measured at week 2 of radiotherapy. Results: 14 patients were recruited (6 scanned on diagnostic MR and 8 on MRI-linac), with a total of 24 lesions. Baseline Ktrans estimates were comparable on both MR systems; 0.13 [95 %CI: 0.10 to 0.16] min−1 (diagnostic MR) and 0.15 [0.12 to 0.18] min−1 (MRI-linac). wCV values were 22.6 % [95 % CI: 16.2 to 37.3 %] (diagnostic MR) and 11.7 % [8.4 to 19.3 %] (MRI-linac). Combined cohort increase in Ktrans was significant (p < 0.01). Similar results were seen for other DCE-MRI parameters. Conclusions: DCE-MRI is feasible on a 1.5 T MRI-linac system in patients with HNC. Parameter estimates, repeatability, and sensitivity to treatment were similar to those measured on a conventional diagnostic MR system. These data support performing DCE-MRI in studies on the MRI-linac to assess treatment response and adaptive guidance based on tumour perfusion.
ISSN:2405-6316