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Comparison of Dose Calculation On Automatically Generated MR-Based ED Maps and Corresponding Patient CT for Clinical Prostate EBRT Plans

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S Renisch

N Schadewaldt1 , H Schulz1 , M Helle1 , M Frantzen-Steneker2 , U Heide2 , S Renisch1*, (1) Philips Research Laboratories Hamburg, Hamburg ,(2) The Netherlands Cancer Institute, Amsterdam


SU-E-J-141 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To analyze the effect of computing radiation dose on automatically generated MR-based simulated CT images compared to true patient CTs.

Methods: Six prostate cancer patients received a regular planning CT for RT planning as well as a conventional 3D fast-field dual-echo scan on a Philips 3.0T Achieva, adding approximately 2 min of scan time to the clinical protocol.
Simulated CTs (simCT) where synthesized by assigning known average CT values to the tissue classes air, water, fat, cortical and cancellous bone. For this, Dixon reconstruction of the nearly out-of-phase (echo 1) and in-phase images (echo 2) allowed for water and fat classification. Model based bone segmentation was performed on a combination of the DIXON images. A subsequent automatic threshold divides into cortical and cancellous bone.
For validation, the simCT was registered to the true CT and clinical treatment plans were re-computed on the simCT in pinnacle³. To differentiate effects related to the 5 tissue classes and changes in the patient anatomy not compensated by rigid registration, we also calculate the dose on a stratified CT, where HU values are sorted in to the same 5 tissue classes as the simCT.

Results: Dose and volume parameters on PTV and risk organs as used for the clinical approval were compared. All deviations are below 1.1%, except the anal sphincter mean dose, which is at most 2.2%, but well below clinical acceptance threshold. Average deviations are below 0.4% for PTV and risk organs and 1.3% for the anal sphincter. The deviations of the stratifiedCT are in the same range as for the simCT. All plans would have passed clinical acceptance thresholds on the simulated CT images.

Conclusion: This study demonstrated the clinical usability of MR based dose calculation with the presented Dixon acquisition and subsequent fully automatic image processing.

Funding Support, Disclosures, and Conflict of Interest: N. Schadewaldt, H. Schulz, M. Helle and S. Renisch are employed by Phlips Technologie Innovative Techonologies, a subsidiary of Royal Philips NV.

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