TY - JOUR
T1 - Development and Testing of a Magnetic Resonance (MR) Conditional Afterloader for Source Tracking in Magnetic Resonance Imaging-Guided High-Dose-Rate (HDR) Brachytherapy
AU - Beld, Ellis
AU - Seevinck, Peter R
AU - Schuurman, Jeroen
AU - Viergever, Max A
AU - Lagendijk, Jan J W
AU - Moerland, Marinus A
N1 - Funding Information:
Conflict of interest: This work was supported by the Eurostars Programme, ITEA3, project name: System of Real-Time Systems (SoRTS), grant number: 12026.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/11/15
Y1 - 2018/11/15
N2 - PURPOSE: For the purpose of magnetic resonance imaging (MRI)-guided high-dose-rate (HDR) brachytherapy, a prototype magnetic resonance (MR) conditional afterloader was developed. This study demonstrates the development and testing of the prototype, while operating simultaneously with MRI. In combination with an MR-based method for HDR source localization, this development enables treatment verification of HDR brachytherapy. Additionally, this allows a direct reconstruction of the source dwell positions after catheter insertion (when using a dummy source) and introduction of a clinical workflow where the patient remains in the same position during dwell position reconstruction, treatment planning and irradiation.METHODS AND MATERIALS: A prototype MR conditional afterloader was developed by providing radiofrequency (RF) shielding and a plastic source cable containing a dummy source. Simultaneous functioning of the afterloader and MRI acquisition was tested in an experimental setting where the afterloader was placed next to the scanner and programmed to send the source to predefined positions within a phantom, while acquiring MR images. The HDR source positions were determined using MR artifact simulation and matching of the MR images to the simulated artifact. Additionally, the impact of the presence and use of the afterloader on the MRI performance was investigated by assessment of RF interference, signal-to-noise ratio (SNR), and B0 field homogeneity.RESULTS: The experiments demonstrated that the prototype MR conditional afterloader and the MRI scanner fully functioned while operating simultaneously, without influencing the other system. The step sizes between the source positions obtained from the MR images corresponded with the afterloader settings. Besides, the MRI performance tests demonstrated no deterioration due to the presence or functioning of the afterloader next to the scanner.CONCLUSIONS: This research has demonstrated the feasibility of simultaneous MR acquisition and employment of an MR conditional afterloader. This development enables real-time HDR source localization for treatment verification of MRI-guided HDR brachytherapy using an MR conditional afterloader.
AB - PURPOSE: For the purpose of magnetic resonance imaging (MRI)-guided high-dose-rate (HDR) brachytherapy, a prototype magnetic resonance (MR) conditional afterloader was developed. This study demonstrates the development and testing of the prototype, while operating simultaneously with MRI. In combination with an MR-based method for HDR source localization, this development enables treatment verification of HDR brachytherapy. Additionally, this allows a direct reconstruction of the source dwell positions after catheter insertion (when using a dummy source) and introduction of a clinical workflow where the patient remains in the same position during dwell position reconstruction, treatment planning and irradiation.METHODS AND MATERIALS: A prototype MR conditional afterloader was developed by providing radiofrequency (RF) shielding and a plastic source cable containing a dummy source. Simultaneous functioning of the afterloader and MRI acquisition was tested in an experimental setting where the afterloader was placed next to the scanner and programmed to send the source to predefined positions within a phantom, while acquiring MR images. The HDR source positions were determined using MR artifact simulation and matching of the MR images to the simulated artifact. Additionally, the impact of the presence and use of the afterloader on the MRI performance was investigated by assessment of RF interference, signal-to-noise ratio (SNR), and B0 field homogeneity.RESULTS: The experiments demonstrated that the prototype MR conditional afterloader and the MRI scanner fully functioned while operating simultaneously, without influencing the other system. The step sizes between the source positions obtained from the MR images corresponded with the afterloader settings. Besides, the MRI performance tests demonstrated no deterioration due to the presence or functioning of the afterloader next to the scanner.CONCLUSIONS: This research has demonstrated the feasibility of simultaneous MR acquisition and employment of an MR conditional afterloader. This development enables real-time HDR source localization for treatment verification of MRI-guided HDR brachytherapy using an MR conditional afterloader.
KW - Brachytherapy/methods
KW - Humans
KW - Magnetic Resonance Imaging/methods
KW - Radiotherapy Dosage
KW - Radiotherapy, Image-Guided/methods
KW - Signal-To-Noise Ratio
UR - http://www.scopus.com/inward/record.url?scp=85048536013&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2018.04.066
DO - 10.1016/j.ijrobp.2018.04.066
M3 - Article
C2 - 29891205
SN - 0360-3016
VL - 102
SP - 960
EP - 968
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -