TY - JOUR
T1 - Delineation of a Cardiac Planning Organ-At-Risk Volume Using Real-Time Magnetic Resonance Imaging for Cardiac Protection in Thoracic and Breast Radiation Therapy
AU - Henke, Lauren E.
AU - Contreras, Jessika A.
AU - Mazur, Thomas
AU - Green, Olga
AU - Daniel, Nalini
AU - Lashmett, Hilary
AU - Senter, Tammy
AU - Gach, H. Michael
AU - Ochoa, Laura
AU - Mutic, Sasa
AU - Zoberi, Imran
AU - Bradley, Jeffrey
AU - Robinson, Clifford
AU - Thomas, Maria A.
N1 - Funding Information:
Sources of support: This publication was supported by the Washington University Institute of Clinical and Translational Sciences (grant UL1T2000448 from the National Center for Advancing Translational Sciences , National Institutes of Health). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Sources of support: This publication was supported by the Washington University Institute of Clinical and Translational Sciences (grant UL1T2000448 from the National Center for Advancing Translational Sciences, National Institutes of Health). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Conflicts of interest: Dr Henke reports grants and other from ViewRay, Inc., as well as grants from Varian outside of the submitted work. Dr Zoberi reports other from ViewRay, Inc. outside of the submitted work. Dr Green reports personal fees and other from ViewRay, Inc. outside of the submitted work. Dr Gach reports other from ViewRay, Inc. outside of the submitted work. Dr Mutic reports grants and other from ViewRay, Inc., grants and other from Varian Medical Systems, other from Philips Health Care, other from Siemens, other from TreatSafely, LLC, and other from Radialogica, LLC outside of the submitted work. Dr Bradley reports grants and other from ViewRay, Inc., grants from Mevion Medical Systems, Inc., and other from Varian Medical Systems outside of the submitted work. Dr Robinson reports grants and other from Varian Medical Systems, and other from Radiologica, LLC outside of the submitted work. Dr Thomas reports other from ViewRay, Inc. outside of the submitted work.
Publisher Copyright:
© 2018 American Society for Radiation Oncology
PY - 2019/5
Y1 - 2019/5
N2 - Purpose: Cardiac radiation is associated with cardiotoxicity in patients with thoracic and breast malignancies. We conducted a prospective study using cine magnetic resonance imaging (MRI) scans to evaluate heart motion. We hypothesized that cine MRI could be used to define population-based cardiac planning organ-at-risk volumes (PRV). Methods and Materials: A total of 16 real-time acquisitions were obtained per subject on a 1.5 Tesla MRI (Philips Ingenia). Planar cine MRI was performed in 4 sequential sagittal and coronal planes at free-breathing (FB) and deep-inspiratory breath hold (DIBH). In-plane cardiac motion was assessed using a scale-invariant feature transformation–based algorithm. Subject-specific pixel motion ranges were defined in anteroposterior (AP), left-right (LR), and superoinferior (SI) planes. Averages of the 98% and 67% of the maximum ranges of pixel displacement were defined by subject, then averaged across the cohort to calculate PRV expansions at FB and DIBH. Results: Data from 20 subjects with a total of 3120 image frames collected per subject in coronal and sagittal planes at DIBH and FB, and 62,400 total frames were analyzed. Cohort averages of 98% of the maximum cardiac motion ranges comprised margin expansions of 12.5 ± 1.1 mm SI, 5.8 ± 1.2 mm AP, and 6.6 ± 1.0 mm LR at FB and 6.7 ± 1.5 mm SI, 4.7 ± 1.3 mm AP, and 5.3 ± 1.3 mm LR at DIBH. Margins for 67% of the maximum range comprised 7.7 ± 0.7 mm SI, 3.2 ± 0.6 mm AP, and 3.7 ± 0.6 mm LR at FB and 4.1 ± 0.9 mm SI, 2.7 ± 0.8 mm AP, and 3.2 ± 0.8 mm LR at DIBH. Subsequently, these margins were simplified to form PRVs for treatment planning. Conclusions: We implemented scale-invariant feature transformation-based motion tracking for analysis of the cardiac cine MRI scans to quantify motion and create cohort-based cardiac PRVs to improve cardioprotection in breast and thoracic radiation.
AB - Purpose: Cardiac radiation is associated with cardiotoxicity in patients with thoracic and breast malignancies. We conducted a prospective study using cine magnetic resonance imaging (MRI) scans to evaluate heart motion. We hypothesized that cine MRI could be used to define population-based cardiac planning organ-at-risk volumes (PRV). Methods and Materials: A total of 16 real-time acquisitions were obtained per subject on a 1.5 Tesla MRI (Philips Ingenia). Planar cine MRI was performed in 4 sequential sagittal and coronal planes at free-breathing (FB) and deep-inspiratory breath hold (DIBH). In-plane cardiac motion was assessed using a scale-invariant feature transformation–based algorithm. Subject-specific pixel motion ranges were defined in anteroposterior (AP), left-right (LR), and superoinferior (SI) planes. Averages of the 98% and 67% of the maximum ranges of pixel displacement were defined by subject, then averaged across the cohort to calculate PRV expansions at FB and DIBH. Results: Data from 20 subjects with a total of 3120 image frames collected per subject in coronal and sagittal planes at DIBH and FB, and 62,400 total frames were analyzed. Cohort averages of 98% of the maximum cardiac motion ranges comprised margin expansions of 12.5 ± 1.1 mm SI, 5.8 ± 1.2 mm AP, and 6.6 ± 1.0 mm LR at FB and 6.7 ± 1.5 mm SI, 4.7 ± 1.3 mm AP, and 5.3 ± 1.3 mm LR at DIBH. Margins for 67% of the maximum range comprised 7.7 ± 0.7 mm SI, 3.2 ± 0.6 mm AP, and 3.7 ± 0.6 mm LR at FB and 4.1 ± 0.9 mm SI, 2.7 ± 0.8 mm AP, and 3.2 ± 0.8 mm LR at DIBH. Subsequently, these margins were simplified to form PRVs for treatment planning. Conclusions: We implemented scale-invariant feature transformation-based motion tracking for analysis of the cardiac cine MRI scans to quantify motion and create cohort-based cardiac PRVs to improve cardioprotection in breast and thoracic radiation.
UR - http://www.scopus.com/inward/record.url?scp=85060891175&partnerID=8YFLogxK
U2 - 10.1016/j.prro.2018.12.004
DO - 10.1016/j.prro.2018.12.004
M3 - Article
C2 - 30576844
AN - SCOPUS:85060891175
SN - 1879-8500
VL - 9
SP - e298-e306
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 3
ER -