SU-G-JeP2-10: On the Need for a Dynamic Model for Patient-Specific Distortion Corrections for MR-Only Pelvis Treatment Planning.

PURPOSE: Patient-specific distortions, particularly near tissue/air interfaces, require assessment and possible corrections for MRI-only radiation treatment planning (RTP). However, patients are dynamic due to changes in physiological status and motion during imaging sessions. This work investigated the need for dynamic patient-specific distortion corrections to support pelvis MR-only RTP.

METHODS: The pelvises of healthy volunteers were imaged at 1.0T, 1.5T, and 3.0T. Patient-specific distortion field maps were generated using a dual-echo gradient-recalled echo (GRE) sequence with B0 field maps obtained from the phase difference between the two echoes acquired at two timepoints: empty and full bladders. To quantify changes arising from respiratory state, end-inhalation and end-expiration data were acquired. Distortion map differences were computed between the empty/full bladder and inhalation/expiration to characterize local changes. The normalized frequency distortion distributions in T2-weighted TSE images were characterized, particularly for simulated prostate planning target volumes (PTVs).

RESULTS: Changes in rectal and bowel air location were observed, likely due to changes in bladder filling. Within the PTVs, displacement differences (mean ± stdev, range) were -0.02 ± 0.02 mm (-0.13 to 0.07 mm) for 1.0T, -0.1 ± 0.2 mm (-0.92 to 0.74 mm) for 1.5T, and -0.20 ± 0.03 mm (-0.61 to 0.38 mm) for 3.0T. Local changes of ∼1 mm at the prostate-rectal interface were observed for an extreme case at 1.5T. For end-inhale and end-exhale scans at 3.0T, 99% of the voxels had Δx differences within ±0.25mm, thus the displacement differences due to respiratory state appear negligible in the pelvis.

CONCLUSION: Our work suggests that transient bowel/rectal gas due to bladder filling may yield non-negligible patient-specific distortion differences near the prostate/rectal interface, whereas respiration had minimal effect. A temporal patient model for patient-specific distortion corrections may be advantageous for MR-only RTP, although further investigations in larger cohorts are needed to fully characterize distortion magnitude. The submitting institution has research agreements with Philips Healthcare. Research sponsored by a Henry Ford Health System Internal Mentored Grant.